Chin augmentation is a great way to enhance one’s facial profile if the lower facial prominence is recessed. The use of a chin implant is the most common method to make this facial change. It is typically perceived as a horizontal change or increasing the most anterior soft tissue point of the chin in the side view. This is of value in both men and women but, particularly in men, where a stronger chin creates a more masculine appearance.
But perceiving chin augmentation as just a horizontal change overlooks that it can also impact the frontal appearance of the chin as well. Its vertical length and horizontal width are other important dimensions of the chin that are frequently overlooked. These can also be changed by the type and size of implant selection.
In men, a strong chin can be a favorable facial trait. In the frontal view, one of the determinants of a strong chin feature is its width. Chin implants today can make significant width increases by their design. The square chin implant is one specific style that is intended to make a wider and less rounded chin. It is almost exclusively requested and used in male chin augmentation.
Square chin implants are designed so that there is a frontal ‘bumper’ or block square segment of material across its front. Rather than being rounded as it curves around the edge of the chin, it is squared off and then makes more of a right angle change into the side of the implant. Currently, there are several commercially-available square chin implant designs. In silicone materials, two styles of square chins exist with one having more square width than the other. In porous polyethylene (Medpor), an adjustable square chin is available. This is not only because it has an inherent square front shape but because there is a central connector tab between the two implant halfs. The amount of insertion of the tab between the two halfs allow for some degree of extra widening of the implant, up to an extra 10mms. (this also provides an opportunity to make a vertical chin cleft as well)
When it comes to a square chin, how much is enough? What is the aesthetically pleasing amount of ‘squareness’ that a chin should have if one so desires to make this change? As a general rule, a pleasing and balanced square chin should not exceed a vertical line dropped down from the corners of the mouth. The measurement of the width of the mouth from one corner to the other can be transferred to the width of the square component of the implant. When the right angle of a square chin goes beyond this line, it will cause a noticeable dip or divot to appear along the side of the jawline as it transitions backward. This creates an uneven and unnatural looking jawline.
Smaller versions of square chin implants can be made from any of the many larger non-square or round chin implants. The rounded front edge of an implant can be shaved down or made flat during surgery so the front edge of the implant is more square. How much horizontal augmentation needed must be carefully calculated so that in making the chin implant more square, the amount of desired horizontal increase is not dimnished. Custom square chin implants can also be made to allow for more extreme chin width increases.
Square chin implant augmentation is an aesthetic option for those men who want a stronger appearing chin in the frontal view. Whether this is a good option and looks reasonably natural depends on the shape of the rest of the face and that the implant is not oversized.
Dr. Barry Eppley
Indianapolis, Indiana