In the new textbook OPERATIVE TECHNIQUES IN CRANIOFACIAL SURGERY I co-wrote a chapter on aesthetic chin surgery entitled ‘Alloplastic Chin Augymentation’. In this chapter is described the basic techniques for the aesthetic correction of chin deficiencies using implants. While this procedure is often viewed as ‘simple’, it often is not well performed with implant selection inadequacies and bony placement malpositions.
Silicone chin implants are the most commonly used as they fall into the implant philosophical approach of ‘easy in, easy out…and easy back in’. While every patient hopes to have an implant surgery that is a ‘one and done’, the reality is that up to one-third of any aesthetic implant placed in the body will undergo an eventual revision or removal. Chin implants are no exception.
The surgical approach to chin implant placement can be either done from the outside (submental skin approach) or from inside the mouth. (intraoral approach) There are advantages and disadvantages with either approach. The more commonly used submental skin approach can be done with a very small skin incision through which subperiosteal dissection can be done and the pocket created. Because silicone implants are flexible they can be placed through remarkably small skin incisions. Most of the pocket dissection is done blind and heavily guided by external palpation. The intraoral placement technique uses a midline mentalis muscle split method. It is not necessary to completely sever the attachment of the mentalis muscle as many surgeons do to either make the subperiosteal pocket or place the implant into it..
Dr. Barry Eppley
Indianapolis, Indiana