While a facelift procedure can have a dramatic effect on the neck, how significant that result can be is partially influenced by the position of the chin. Short chins are often associated with a short neck, limiting the results of any facelift procedure.
Because of the significance of the position of the chin as the most anterior point of the jawline, a large percent of facelift patients also receive chin augmentation as well. This is most commonly done with a chin implant placed on top of the bone through a small submental incision.
The shorter the chin, the more important it is that one seriously consider simultaneous chin enhancement. In smaller chins, most patients already know or have thought about it so it is not a novel concept. In more mild chin deficiencies, however, manipulation of the chin is introducing a new and unexpected procedure. Computer imaging for these patients is crucial and the visual difference, with and without a chin implant, helps patients make the right decision for them.
How much the chin should be advanced in a facelift is matter of judgment and how deficient the chin is. While bringing a chin forward to meet the classic vertical drop down line from the lips is correct on paper, that may or may not be too much for some patients. The value of computer imaging comes into play again here by making several predictions based on small, medium, and larger chin advancements. In my Indianapolis plastic surgery practice, I always let the patient decide their preference. While most of the time, I could use my own judgment and be correct, sometimes you can be fooled by what a patient may prefer.
In addition to using a chin implant as providing anterior or horizontal projection, they can also be used to provide enhancement of the inferior border of the jawline as well. Today’s ‘wrap-around’ chin implant styles allow the wings of the implant to go back much further than just the front of the chin. By so doing, I can increase the fullness of the chin from the frontal view as well as add volume along the sides of the chin as it goes back into the jawline. Having an implant in this area can help soften the bottom edge of the marionette lines (coming down from the mouth) and improve notching from soft tissue overhang in this area.
Chin implants are a valuable complement to many facelifts. Their different sizes and styles enhances the look of a facelift and provides a rejuvenated look to the chin and front part of the jawline.
Dr. Barry Eppley
Indianapolis, Indiana