Chin augmentation is an aesthetic facial procedure that has been done for just about 100 years. The first reported procedure was done way back in 1928 using a cartilage graft to the chin. The use of carved ivory was also done in the early chin augmentation days. But the procedure never achieved any popularity in plastic surgery until the concept of an implant material for aesthetic chin augmentation was done starting in the 1950s. Silicone was always the first synthetic material tried but not always in the way it is used today.
The original silicone chin implant emerged in 1948 with the development of a solid Silastic block of material from which the surgeon could carve their own implant. But the first truly preformed chin implant emerged in 1966 with anatomic and extended implant styles. It is not clear whgen the non-solid gel chin implant came into clinical use but it was still a Dow Corning product. It was not a solid material but a gel placed in a bag. (shell) The concept was identical to how breast implants have always been done. It is not clear how this implant concept developed. It may have been from the historic use of liquid silicone injections for facial augmentation with their known complications… isolating the liquid silicone in bag was seen as a method to decrease the body’s potential inflammatory response to it. (which is biologically valid) Or it was a natural spin off of the development of the breast implant (late 1960s) in a miniaturized facial form. I suspect the latter is its origin since it was a logical extension of a known concept.
Such silicone gel chin implants were commercially available up until the late 1980s. While the likelihood of seeing a patient with a silicone gel implant still in place today is very unlikely it is still possible. I recently performed a chin implant replacement on a patient who had the original chin implant procedure done 45 years ago….exactly when such implants were still being done. With time of implantation I suspected it would be a gel implant and that turned out to be accurate. On entering the implant capsule silicone gel came oozing out. (ruptured implant) On removing the implant it was a classic silicone gel implant now devoid of some of its gel material. (deflated)
Seeing a silicone gel chin implant is plastic surgery history, looking at a concept that was abandoned long ago for an improved implant design. Because this patient was in his late 60s it was still possible to see such an historic implant. He never had any problems with the implant he just desired to have a more significant chin augmentation effect. There was no adverse tissue reaction to the implant despite it being ruptured. The capsule was of normal thickness and the underlying bone has a smooth cortical contour. There was some bony ovegrowth on its superior surface which is commonly seen.
Dr. Barry Eppley
World-Renowned Plastic Surgeon