The prominence of the chin, the projecting anterior point of the lower jaw, is a facial feature sought by many men. The shape of the chin, however, has other features than just an anterior prominence. It has the other dimensional features of width and vertical length as well as unique surface topography in dimples and clefts.
Often described as the same feature, dimples and clefts of the chin are both different in appearance as well as in anatomy. A chin dimple is a circular indentation in the center of the soft tissue pad and it is exclusively by a soft tissue defect of the muscle and subcutaneous tissue. There us never an underlying central indentation in the bone. A chin cleft is a vertical groove located in the lower center of the chin of variable depths and widths. It is also primarily a soft tissue defect although there can be midline indentations in the underlying bone. Surgical procedures exist to both create and remove chin dimples and chin clefts.
In chin implants, in an effort to create both an augmentation and a midline cleft, cleft chin implants have been devised. While their concept seems sound the reality is these types of chin implants do no create the external appearance of a vertical chin cleft. If the cleft in the implant is big and wide enough perhaps a hint of an external cleft can be created, but it does not work for a simple anatomic reason….the cleft is in the soft tissues.
In the emerging world of custom facial implants, in particular custom jawline implants, some patients do want a vertical cleft placed in the implant in the hope that its shape will show through. But unless the overlying soft tissues are managed through a submental incision, the central indentation of the implant will largely remain obscured.
Dr. Barry Eppley
Indianapols Indiana