Background: Strong chin augmentation effects in men requires variations of standard types of procedures. The interpretation of what a strong chin augmentation means is open to individual interpretation. While usually referring to the amount of forward chin projection, with or without vertical lengthening, it may also be referring to a less round or more square shape. While angularity is frequently thought of as referring to the jaw angles it can also be applied to the chin, specifically the chin corners. A more square chin shape is seen as a more angular chin.
The reagent for s strong chin appearance often occurs in the male patient who has had a prior chin augmentation procedure. Whether it is a chin implant or a sliding genioplasty the patient has ‘learned’ that, while their initial result is better than what they originally had, their ideal chin augmentation goal is more. In some cases this may be a minor amount but in the patient who wants a major improvement standard approaches to that change will far short. The surgeon must be prepared to embark on a new approach.Or to say it another way…extraordinary results require extraordinary surgery.
Custom chin implant designs are appropriate when either a bigger size (more projection) is needed than what standard implants can do or when a specific shape change is needed. In men such shape changes usually refer to a more square shape while in women the shape change is more narrow or triangular. When you combine the need for a larger amount of projection with a square shape in men then a custom implant design is needed. Large sliding genioplasties can also create strong chin projection changes but they will always make the chin more narrow. (never more square)
Case Study: This male had a prior history of a standard chin implant which did not create his desired result and was also asymmetric in shape and placement.
A custom chin implant was designed that added more horizontal projection (5.5mm to 11mm), added vertical lengthening (0mm to 3mm) and had a distinct square chin shape.
Under general anesthesia and through a submental skin incision his existing chin implant was removed and replaced with the ne custom chin implant. Because of his projection and and width and limited wings 3 12mm screws were used to secure to the bone.
His immediate change with the custom chin implant replacement achieved a stronger and more square chin shape. Per his preoperative goal the chin can not be made too strong.
While a chin implant can be designed with any shape on paper there are limits as to the tolerance of the soft tissues to contain it.The rule of 15 applies in which the cumulative dimensional changes should not excess this number. The very square shape adds +1` to the dimension so this also needed to be figured into this number.
Highlights:
- Square shaped chin augmentation results in men rarely are ideally achieved with standard implants.
- In designing square chin implants width is less important than the shape of the corners of the implant.
- Large chin implants sizes may require then presence of an indwelling implant to be achieved.
Dr. Barry Eppley
World-Renowned Plastic Surgeon