The term, glass chin, has been around for a long time. It is typically used in combat sports, such as boxing and martial arts, to describe a fighter who is susceptible to being knocked out or hurt by a punch to the front part of their jaw. Since the chin is a protruding facial structure that is the easiest part of the face to hit, a fighter’s chin casts an image as to their ability to tolerate physical trauma to the face. This is why a fighter with a good chin, aka granite chin or iron chin, is viewed as having the ability to absorb punishment without being knocked unconscious.
While this is interesting commentary on sporting lingo, it normally would have no relevance to plastic surgery. (unless I had to fix a broken jaw in a fighter) That is what I thought until just a week ago. During a surgical procedure to remove and replace a man’s chin implant, I came across a true glass chin.
I had an out of town patient who, amongst other procedures, wanted his existing chin implant removed. He said he never really thought he needed it anyway and was bothered by its very hard feel. It also made his chin feel stiff up under his lower lip. Through a submental incision, I dissected down through his chin tissues to the patient’s indwelling chin implant. Because it had been placed elsewhere through an intraoral approach, I knew it would be in a high position on the chin bone. It was at least a centimeter above the lower edge of the chin bone when I encountered the implant capsule.
On cutting through the capsule with a cautery, the underlying implant felt unusually hard. Even though it was clear, a sign that it would normally be made of silicone, it was instead hard. So hard that tapping on it made it sound like glass. Unlike a silicone rubber chin implant, which folds on itself and makes it easy to remove, the implant was rock solid. It required the entire implant capsule to be opened for its removal.
On its removal, it could be seen that it not only was made of a hard and inflexible plastic (glass??) but it was also a cleft chin style. I have never seen or even heard of a manufacturer who would make a facial implant out of this hard material. Nor can I envision why anyone would. It not only was hard and poorly shaped, it was very short in horizontal dimension. It was very hard and diminuitive compared to traditional silicone chin implants.
I can now say that I actually have seen a patient who truly had a glass chin.
Dr. Barry Eppley
Indianapolis, Indiana