While chin enhancement in both increased projection and width is desireable in men, the exact opposite is true in women. A narrower more refined chin helps contribute to a more oval facial form. When one looks at a woman’s face and it is more square, the question is whether this is due to a bony prominence at the mandibular (jaw) angles, whether it is due to a square chin shape, or both. If a wide square chin is the main contributor to the undesired lower facial contour, then bony reduction of the chin can be performed.
Bony chin reduction by burring or shaving down the lower border is one approach which has its own distinct advantages. Its only disadvantage is the external submental scar. produces only a minimal result. An alternative technique which is ‘scarless’ is the intraoral osteotomy method. .In the July 2008 issue of Plastic and Reconstructive Surgery, a paper was published which described an integral technique by a chin osteotomy and midline resection. This is an easy variation of a chin osteotomy and I have also found it very successful for chin narrowing. (and it can be used for chin widening as well) One of the key technical points is to make sure to burr down the edge of the bone where the lateral side of the chin is moved in and to resuspend the mentalis muscle well. The risk of temporary mental nerve numbness should be the same as with shave reduction only as nearly same amount of soft tissue stripping is needed.
Like all chin osteotomies, there is more swelling and temporary numbness than will occur from a chin implant for example. But the long-term result is worth it. Chin narrowing, combined with mandibular angle reduction, can be very effective in the most square of faces.
Dr. Barry Eppley
Indianapolis, Indiana