Background: The submental (under the chin) incision for placement of chin and custom jawline implants are a standard approach. This inferior approach offers a safer approach to avoiding injury to the mental nerve with implant placement as well as lessens the risk of infection compared to intraoral incisions. The tradeoff is that of a a scar but given its location on the underside of the chin it usually is fairly hidden in the frontal view.
The chin is an area that is prone to trauma from falls and other mechanisms of injury particularly as children or teenagers. Thus it is not uncommon to see a chin or custom jawline implant patient with such chin scars from prior injuries. Most of the time these chin scars are not completely in the siubmental region but closer to the end of the chin where the traumatic injury is more likely to occur onto the projecting chin point.
When such chin scars are present the interesting questi0n is whether they should/can be used instead of making a new submental incision cresting a second scar in the region.
Case Study: This male presented for a custom jawline implant with an existing oblique chin scar. It was further anterior than a submental incision would be placed but it did have adequate length.
Under general anesthesia and through this chin scar the custom jawline implant was placed in the traditional manner. A single fixation screw was used through its midline marker of the chin part of the implant.
After the placement of Vancomycin antibiotic powder the scar was closed in multiple layers with resorbable sutures.
The two important considerations as to whether a chin scar scar can be used for implant placement is its length and the size of jaw angle and chin parts of the custom implant. The length of the chin scar should be at least 2 to 2.5cmw int length. The jaw angle size of the implant must be small enough to fit through the length of the scar. The projection of the chin part of the implant is important as there will always be some rollout of the soft tissue chin pad with the placement of any chin implant. The more horizontal projection the chin implant has the greater that rollout will be. Increased rollout will move the chin scar further anterior and make it more potentially exposed in the front view. This has to be considered when determining whether a new more posterior scar may be better.
Case Highlights:
1) Chin scars are frequently seen in patients presenting for standard chin and custom jawline implants.
2) The length of the existing chin scar determines whether it can be used for implant placement not its location or orientation.
3) A custom jawline implant can be placed through many existing traumatic chin scars.http://www.eppleycustomfacialimplants.com
Dr. Barry Eppley
World-Renowned Plastic Surgeon