1. How do I know a chin augmentation will make my face look better?
One of the important elements in improving facial attractiveness is balance and proportion. Chin augmentation is about improving the proportions of the lower face in both horizontal (lateral view) and vertical (frontal view) dimensions. The beauty of chin surgery is that it can be visualized very accurately before having surgery through computer imaging. Morphing the profile of the chin in all dimensions can be quickly and easily done since it is a facial prominence that is isolated like a projecting rock from a cliff. While you or your plastic surgeon may feel that chin augmentation would be beneficial, the guess work can be taken out of that consideration by imaging of your photographs.
2. What are chin implants made of?
By far, most of the chin implants used are made of silicone rubber, also known as silastic. This inert material is one of the most biocompatible of allbiomnaterials, is made in dozens of different shapes and sizes, and is inexpensive. Other implant materials are also used of which Medpor (polyethylene) is the most well known. It is a porous plastic material that is stiffer (needs a bigger incision to insert)and more expensive. Rarely used are other materials including Gore-tex and Mersilene mesh.
Given these different implant options, patients often ask which one is best. While certain plastic surgeons may advocate one over the other, the body does not really see them as any different. The shape or type of chin implant used is by far more important than the material from it is made. Given that today’s implants can change numerous dimensions of the chin, one should focus on these change possibilities and how they may be aesthetically beneficial.
3. What is the best way to place a chin implant, through the mouth or from under the chin?
Chin implants can be introduced through an incision inside the mouth behind the lower lip (vestibular) or through the skin from under the chin. (submental) While either approach will work, the submental incision is best in most cases for several reasons. First and foremost, this approach does not disrupt the superior insertion of the mentalis muscle so there is no risk of a chin sag afterwards. Secondly, there is no risk of the implant moving higher up on the chin bone since the upward end of the pocket stays naturally lower when made from below. Lastly, there tends to be less pain afterwards as the pocket dissection does need to be as big to get the implant in place.
4. Will I be able to eat and drink right after surgery?
Yes. Since the chin implant is on the front end of the jaw bone (mandible),it is does not interfere with jaw movement or opening one’s mouth. It is also places no restriction on chewing or swallowing. If an incision is used from inside the mouth, I merely tell patients not to bite food off but to use utensils to bypass what your front teeth normally do When the incision is used from under the chin, there are no restrictions at all
.
5. I heard that the chin bone can be cut and moved forward (osteotomy) instead of an implant. Which is better?
Another well known method of chin augmentation is to move the chin bone forward rather than using a synthetic implant. While much less commonly performed than an implant, an osteotomy can be a good option for the right patient. Since it is a ‘bigger’ operation that takes longer to do and incurs more expense, proper patient selection is critical.
In my Indianapolis plastic surgery practice, I use the following three indications for a chin osteotomy. A young patient, the need for significant horizontal advancement, and if one is undergoing facial bone movements (orthognathic surgery)at the same time. The value of a chin osteotomy is that it can avoid a large implant that must remain complication-free over a long patient life-time.
A chin osteotomy can also do one thing that an implant can not. It can lengthen the chin vertically. While minor amounts of vertical height increase can be obtained by a low position of an implant, significant lengthening requires an interpositional graft after the chin segment is brought downward.
6. Can a chin augmentation be done with other facial procedures at the same time?
Yes. In fact, most chin augmentation procedures are usually part of combination facial plastic surgery. Most commonly, chin enhancement is done with rhinoplasty in a young patient and with a facelift in older patients. It is also one of the procedures in the facial ‘trifecta’ for men…chin, cheek, and jaw angle augmentation.
7. If I play sports, will having a chin implant be a problem?
The risk of getting hit in the chin is a common one in many types of sporting activities. Trauma to a chin implant will not cause it to break or fracture but it may move it shift or move out of place. For this reason, I prefer to place a screw to secure it into place in younger male patients who participate in any form of contact sports.
Dr. Barry Eppley
Indianapolis, Indiana