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Posts Tagged ‘square chin implant’

Case Study – Square Chin Implant

Saturday, May 14th, 2016

 

Background:  Chin augmentation is one of the most popular lower facial reshaping procedures and has been so for many decades. Its benefits are most commonly perceived in the side profile demonstrating increased horizontal projection of the chin. While changes in how far the chin projects forward is one of the most important benefits of a chin implant, that view alone is an inadequate perception of the overall chin augmentation  effect.

Chin augmentation should be seen as a 3D procedure and not just a 2D one. This takes into account the frontal view as well, assessing the vertical and transverse dimensions. The frontal view of the chin includes its width which is highly gender specific. The female chin ideally has a amore narrow and tapered shape. Conversely the male chin is wider, more angular  and can even have a square shape.

While there are numerous styles of chin implants, they have only two basic frontal shapes…convex and square. The square chin implant is unique in that it maintains a square shape when applied to the front edge of the chin bone which is usually convex. It does so because it is thicker on the sides of the chin so when pressed against the bone it maintains a square shape.

Case Study: This 45 year-old male had a chin implant placed several years previously through an intraoral approach. While it did improve his profile, he had been unhappy with how his chin looked straight on and he also felt it was sitting too high. He wanted more of a masculine square chin shape.

Chin Implant Removal Dr Barry Eppley IndianapolisChin Implant Replacement Dr Barry Eppley IndianapolisUnder general anesthesia, his existing chin implant was removed through a submental skin incision. The implant was positioned high and was asymmetric in position. It was a central style of chin implant that was curved with no lateral wings. It was replaced with a style 1 square chin implant of similar anterior projection thickness. (7mms) A centrally placed 2 x9mm screw was inserted to ensure its central position low on the chin bone.

Square Chin Implant replacement result Dr Barry Eppley IndianapolisA square chin implant is uniquely made for men who desire a wider and more angular chin shape. It comes in two widths known as a style 1 and style 2 chin. In the style 1 the square chin width is 45mms and in the style 2 the square chin width is 55mms. Which style of square chin width is best for each patient depends on the horizontal width of their mouth and how strong they want the square chin to appear.

Highlights:

1) Chin implants come in both different styles as well as sizes.

2) When considering chin augmentation how the chin will look in the frontal view is often overlooked.

3)  For men who seek a more angular and wider chin look, the square chin implant can help achieve this type of frontal chin shape.

Dr. Barry Eppley

Indianapolis, Indiana

Technical Strategies – Square Chin Implant and Vertical Cleft Creation

Friday, February 27th, 2015

square chin implant dr barry eppley indianapolisChin augmentation is most commonly done by placement of a synthetic silicone implant. Chin implants today come in a wide variety of dimensions, historically providing only horizontal projection, but now available in vertical lengthening styles as well. For men chin implants are even available to provide an increase in width, also known as a square chin look, to provide a more masculine chin/jawline appearance.

One other chin feature that is often desired in men is that of a chin cleft. Certain chin implants have a central cleft in them in an effort to create a midline cleft with the chin augmentation. While it looks good on the implant, it does not translate to creating that effect on the outside after implant placement. It simply is not that easy to create a vertical chin as it does not come exclusively from a defect or notch in the bone, contributions also come from a muscular diastasis as well.

square chin split implant technique dr barry eppley indianapolisvertical chin cleft creation technique dr barry eppley indianapolisTo effectively create a vertical chin cleft at the same time as placing a chin implant, it requires a concerted effort to make it appear. The chin implant is first split down the midline and separated. A 5 to 7mm gap is made between the implant. Because the implant is now in two pieces it is necessary to secure each implant half by screw fixation. Then a bone hole is made through the bottom of the chin in the midline. This allows a permament suture to be placed that is used to pul the mentalis muscle down into the implant gap. A stronger effect can be created by removing some soft tissue under the skin as well before passing the suture. How tight the suture is tied down will impact the degree of cleft creation. The shape of the cleft (its width) is also influenced by the size of the midline implant gap.

Square Chin Implant with Cleft result Dr Barry Eppley IndianapoliisA vertical chin cleft can be done at the same time as a square chin implant augmentation in men. Breaking up the wider square chin with a cleft helps add a visual feature of interest and disrupts a completely flat horizontal line across the bottom of the chin.

Dr. Barry Eppley

Indianapolis, Indiana

Square Chin Implants in Men

Wednesday, November 21st, 2012

 

The shape and dimensions of the chin has a huge impact on the appearance of the lower face. It is well known that weak vs strong chins give off different impressions of one’s personality, even though these impressions may not really be true. Most commonly, a ‘weak’ chin is treated by an implant which is based almost solely on an artistic assessment of increasing the amount of horizontal projection. But horizontal projection alone is but one dimension of a well proportioned and attractive chin and other dimensions needs to be assessed before surgery as well.

How is a chin assessed before surgery? How is a dimensional chin analysis done? The classic teaching is that one chin’s point should fall on a vertical line drawn down from the glabella on the Frankfort horizontal plane, particularly for a male. This is, of course, just a horizontal assessment. The vertical height of the lower third of the face and chin should be 1/3 of total facial height from the subnasale (base of the nose) down to the menton point. (bottom of the chin) This determination can be done in both the horizontal and frontal views. The width of the chin, however, is the obscure measurement and is not necessarily determined by the classic dividing the face into vertical 1/5s. There are no real established standards set for chin width, like anthropormetrics as done for chin height and length.

While the aesthetics of chin width are open to subjective assessment, there are some anatomic guidelines to use. The width of the chin in men is most aesthetically pleasing (stronger appearance) when it assumes one of two shapes. The first is that the squareness of the chin lies inside a vertical line drawn down from the corners of the mouth. This can be a good shape if one has noticeable jaw angle flare. This creates a jaw line with four distinct points in the frontal view. More square chin widths are also very acceptable but this width should never exceed a vertical line drawn from the center of the pupils in males. This is the greatest amount of chin squareness a man should have less they look cartoonish.

When choosing a chin implant in men, it needs to be determined if a square shape is aesthetically advantageous. The vast majority of chin implants are rounded, so called anatomic, and thus will only create a fuller chin that mimics the shape of the underlying bone. Only a chin implant that is so designated as a square style can broaden visible chin width. This can be done from 4.0 cms up to 5.5cms in square width. This is, in essence, the difference between achieving chin width that’s inside the vertical line from the mouth corners or extends out to or just beyond them. When in doubt about the size of a square chin implant, do not extend the measured width of the mouth in the implant.

The chin of males is characterized by larger sizes in three dimensions (horizontal, vertical and width, height and depth) due to the large underlying jaw. The greater inclination angle of the chin and smaller mentocervical angle also indicate a relatively protruding chin in males when compared to that of females. More careful assessment of chin width in men will find that many could benefit by the addition of some square width for an improved aesthetic result.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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