Moving the chin bone is the simplest of all the cosmetic facial bone procedures. Because the chin is easy to get to through the mouth and there is little in the way to get there, cutting and moving the chin bone (the tip of the front of the lower jaw) is relatively easy do and commonly done. Besides cutting and moving the bone forward to create more chin prominence, bone manipulations of the chin can be much more than just traditional horizontal augmentation.
When the chin bone is cut and dropped down, there are many different shaping procedures that can be done to it. By making a horizontal bone cut below the front teeth, the chin can be changed in length. A wedge of bone can be cut out and the chin brought back up to shorten it in height. Conversely, the chin can be lengthened by placing a bone graft or a piece of synthetic bone in between the two cut ends to make the chin vertically longer. If the chin lengthening is relatively small (a few millimeters), nothing may need to be put in the gap between the bone pieces.
Aside from height changes, alterations can also be done in chin width. The chin bone once cut and brought down from the rest of the jaw, can be widened or narrowed as well. By removing a piece of bone down the middle of the chin bone, it can be brought together in a more narrowed fashion, Similarly, a bone cut can be made down the middle of the chin and it can be split apart and widened. (similar to what it done for lengthening the height of the chin)
With all of these chin changes, small plates and screws are needed to hold the bone segments into the desired positions. This metal hardware is very small and can never be felt from the outside. Over time and with healing, bone overgrows much of these plates and screws. I have never had to remove plates and screws from the chin due to problems with them. They are made of titanium, which is a non-magnetic metal, so there is no concern about ‘setting off the detector at the airport’.
Orthopedic surgery of the chin offers some advantages over more simple chin implants, particularly in changing the dimensions of chin shortening, chin narrowing, and chin lengthening. These are chin changes that implants can not do as their effects are additive, not reductive.
Dr. Barry Eppley
Indianapolis, Indiana