When one thinks of chin augmentation for cosmetic purposes, the use of a chin implant typically comes to mind. And while the vast majority of chin augmentations are, in fact, done with an implant, there are some patients who may better benefit by a different approach. As opposed to putting an implant on top of the chin bone to bring it forward, an alternative approach is to cut the chin bone itself and bring it forward.
A chin implant is a very effective, simple and safe procedure that has very few complications. This accounts for why chin implants are widely used. While chin implants infections and migration (shifting from its desired position) after surgery is uncommon, they are risks nonetheless. Furthermore, when large chin implants are used, they may ‘settle’ into the bone over many years, a phenomenon known as pressure bone resorption. For these reasons, in select patients, moving the chin forward may be a better treatment option.
Chin osteotomies (cutting the bone and moving it forward) is done through an incision inside the mouth. (rather than under the chin as with an implant. It is technically more difficult than an implant and has more swelling and recovery than a simple chin implant. Also, there is usually temporary loss of feeling of the lip and chin after that takes several weeks to months for full return of sensation.
The important question is……who is a better candidate for a chin osteotomy as opposed to a chin implant ? The criteria that I use is….if you have a large chin deficiency and are young (under 30 or so), then the use of a chin osteotomy is a valid consideration. In this type of patient, a bigger operation with more recovery is worth the long-term benefits. Once the bone heals after surgery (which is held into place by small permanent plates and screws), it will stay that way forever without any risks of infection, implant migration, or loss of augmentation (settling into the bone) for the rest of your life.
Dr Barry Eppley
Indianapolis, Indiana