Chin augmentation using an implant is a very common and satisfying plastic surgery procedure of the face. Its success is primarily based on the implant itself, both in size and style type. Surgical placement, whether done through the skin under the chin or through an incision inside the mouth, is straightforward and is not a significant contributor to a good outcome in experienced hands.
In days of old, chin implants were of one main style…a central button type implant which provided forward projection which was limited to the central chin. While this type of implant may be appropriate for a few patients, chin deficiencies are three-dimensional and this style of implant is not appropriate for many of them. Today, numerous styles and sizes of chin implants are available that help better treat a larger number of chin shape problems.
In assessing one’s chin deficiency, it is important to look at the overall face to see how changes in the chin would be most aesthetically beneficial. From this assessment, one can look at the four main chin implant styles. They include anatomic, extended anatomic, pre-jowl, and square types.
Anatomic chin implants are the short in width and are really the original or first generation type implant. It increases the forward projection of the central chin only. This is good for chins, particularly female, in which increasing chin projection will make the chin look narrow as well from a frontal view. This is never good for use in men in my experience.
The extended anatomic chin implant is, by far, the most common one used. With the implant wings which extend out laterally, the increase in forward projection is also accompanied by the side of the chin coming forward (not as much as the central part) as well. These wings taper and blend into the side of the jaw bone so a step-off or sharp transition into the side of the jaw is not seen or felt.
The pre-jowl chin implant is uniquely used for the older patient to help with aging marionette lines. Similar to the extended anatomic implant, its lateral wings are thicker so that fullness can be beneath the vertical skin folds (marionette lines) to help plump them out.
The square chin implant is obviously designed to help male patients achieve a bigger chin that has a more masculine and stronger appearance. Its lateral wings are as thick as the central part which then taper back onto the bone. I have yet to use this implant in a woman.
All chin implant styles come in three or four sizes which differ in projection n thickness and length around the curvature of the chin. In my Indianapolis plastic surgery practice, I like to look at photographs and use computer prediction imaging to help make a style and size selection. While imaging is never completely accurate, it does help communication and understanding…even if nothing is achieved other than the patient pointing out what she is not interesting in looking like.
Dr. Barry Eppley
Indianapolis, Indiana