Background: Chin augmentation is the most commonly performed jawline enhancement procedure. It is also along with rhinoplasty the most common facial bone reshaping operation. Placing an implant over the end of the chin bone is conceptually simple. But the wide variety of chin implant styles and sizes demonstrates that the aesthetics of chin augmentation is not so simple.
While there are no gender specific chin implants made, it is clear that there are differences in the male and female chin. The ideal male chin is known to be stronger (greater horizontal projection), wider and have a more angular or square shape. Conversely the ideal female chin is more narrow, triangular in shape and can tolerate slightly less horizontal projection. The selection and use of chin implants is often done taking these aesthetic concepts into consideration. Unfortunately often they are not and this can create one reason for dissatisfaction from chin implant surgery.
For many female improvement in their chin shape comes best from an overall ‘cupping effect’ on the chin. The chin may need some modest horizontal augmentation but may need some vertical increase as well. The implant then needs to blend into the sides of the chin to maintain a more triangular shape. Such an implant shape does not come in any standard form and must be custom made.
Case Study: This 46 year old female wanted her chin shape improved but did not desire just a simple horizontal advancement. She wanted a modest change but one that had more of an overall chin shape augmentation but still keep a feminine look. She also had bony chin asymmetry as evidenced by a vertically longer genial tubercle on the right side. From her 3D CT scan a custom chin implant was designed and made. The implant design corrected her asymmetry but also keep a more triangular shape.
Under general anesthesia the custom chin implant was placed through a small 2 cm incision in the submental skin crease. The implant as expected (and should) fit perfectly over the chin bone. It was secured into placed with a single 1.5mm titanium screw
Chin augmentation can be accomplished in the majority of cases by using preformed standard implant styles and sizes. From one manufacturer alone (Implantech) there are seven different styles of implants with three or four different sizes. For most people this assortment will be more than adequate. But not every chin augmentation patient fits the normal implant options and this is the role that a custom chin implant serves.
A custom chin implant is often thought of as being for extreme cases where the amounts of chin dimensional changes exceeds what the standard implant can do. While this is certainly one role that a custom chin implant can do well, they can also be used for more modest chin shape changes that are not served by performed standard styles.
Highlights:
1) Chin augmentation is most commonly performed by a variety of standard styles and sizes of implants.
2) Standard styles of chin implants can not add consistent vertical length and can not create a cupping effect over the chin bone.
3) A custom chin implant can be made in any shape and can be a better option for certain types of female chin deficiencies.
Dr. Barry Eppley
Indianapolis, Indiana