Chin augmentation can be done by a variety of methods from non-surgical injectable fillers to surgical implants and bone moving surgery. For some patients an initial non-surgical method is an appealing approach due to its immediate effect with no recovery. The most common fillers used for chin augmentation are hyaluron-based and there are a wide variety of viscosities or G-prime compositions that can be used with differing duration of effects.
Some non-surgical chin augmentation patients will, however, eventually want to graduate to a permanent result. Whether it be a chin implant or a sliding genioplasty the question is always what to do with the existing filler that is in the chin. Some surgeons prefer to have the filler dissolved before the surgery presumably to better judge the chin implant size or how much to move the chin bone forward. This is very reasonable and is relatively simple to do with enzymatic hyaluronidase injections.
But I do not recommend to my patients to routinely have the fillers dissolved before their chin augmentation surgery. If the goal is to get rid of the fillers to avoid an over corrected look, the surgery process will do that very effectively. In some cases where much of the filler is at the bone level, the opening of the tissues allows the filler to seep out when the surgical pocket is created. Or whatever filler is up in the soft tissues the inflammatory process and swelling will expedite the absorption of the ‘trapped’ filler shortly after surgery. But wherever the filler is it is not an obstacle to placing an implant or performing a sliding genioplasty.
In terms of presirgical planning one can factor in a few millimeters of the effect of the injectable filler on the current chin projection. Knowing how many filler syringes have been placed in the chin will help make this estimation. As a general rule one syringe of filler will increase chin projection 1.5 to 2mms maximum. It is also helpful to know what type of filler was used and how long ago it was placed. That will help one gauge how much augmentative effect the fillers still have. This information is, of course, only as estimation but a helpful one in the presurgical planning process.
Dr. Barry Eppley
World-Renowned Plastic Surgeon