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Background: The well known facelift operation affects both hard and soft tissue. It improves the shape of the neck as well as provides increased smoothness among the jawline. It does both because of superolateral soft repositioning helping to unmask a once better defined jawline that has become partially obscured by soft tissue redundancies.

The one lower facial structure that will not be directly improved by a facelift is the chin, particularly one that is horizontally short. While the chin may be slightly more evident with removal of the sagging jowls it can never be made truly more prominent because it is a hard tissue projection. Only adding to a bony prominence by a direct onlay can it be improved.

In the presence of a short chin a facelift can be improve by chin augmentation. Besides the proximity of the chin from a submental incision used for midline neck reshaping in a facelift, it also lengthens the jawline.This jawline extension improves the facial proportions and also establishes further face and neck separation.

Case Study:  This older female was bothered by her neck sagging and development of prominent jaws. She was a petite female of thin body habits and always had a small face. Part of her small face was a horizontally short chin. The short chin and the neck sagging it was a near straight oblique line down from her chin in profile.

Under general anesthesia, she underwent a limited lower facelift with the placement of a small central style chin implant. The improvement in her profile was improved all most as much by the chin augmentation as the neck reshaping and jowl elimination.

In the frontal view the shape of the chin remained round with no increase in width. Any chin width increase would not fit her smaller face.

Chin augmentation can be a good complement to a facelift , just like it is in some rhinoplasty patients. While seen as a facially balancing procedure, in a facelift it is also a direct extender of the jawline anteriorly which works in a diametric fashion to the effects of the facelift posteriorly.

Case Highlights:

1) A facelift helps improve the definition of the jawline but its effects are hampered in the presence of a short chin.

2) Chin augmentation can be a natural complement for many female facelift patients and should be done with a modest to moderate approach.

3) Chin augmentation in females must consider the front view in implant selection to avoid making it too wide.

Dr. Barry Eppley

Indianapolis, Indiana

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