Chin implants come in a wide variety of sizes and shapes. They can be placed either from an intraoral degloving approach from inside the mouth or from an incision underneath the chin. Both can be successful chin augmentation techniques as long as the implant stays where it is placed, albeit with either suture or screw fixation.
In some cases of chin augmentation the amount of horizontal projection is better but may still be deficient from the patient’s perspective. This could be due to either an inadequately sized chin implant or that the patient’s chin deficiency exceeded what standard implants can achieve. More times than not it is the latter. In these situations it is always better to either choose a larger implant if it is available or have a custom one made.
But another technique exists for improving the chin augmentation effect without removing the indwelling implant. This is the technique of facial implant stacking. This is where a new implant is placed on top of the other one. This provides additional horizontal projection and possibly some width if the implant wings are kept. When stacking implants it is important to secure them to the underlying implant as well as to the bone. Double screw fixation is ideally needed to prevent rotation of the overlying stacked implant.
The stacking of chin implants should be reserved for the very rare situations when other more established alternatives do not exist due to either standard implant limitations or for cost reasons.
Dr. Barry Eppley
Indianapolis, Indiana