Chin implants are the oldest form of alloplastic facial augmentation. Such implants have been available for over fifty years. Over half a century of clinical experience has led to many innovations in their shapes and sizes as well as the surgical techniques to place them.
Throughout this history there are currently older patients walking around who have types of chin implants that are no longer commercially available. These will be occasionally encountered as patients seek to exchange them for more contemporary implants for enhanced results or are seen coincidentally in diagnostic x-rays taken for other reasons.
I operated on an older patient recently who wanted a custom jawline implant with a history of two previous chin implants. He had his first chin implant placed 35 years ago followed by second chin implant done 15 years ago. I assumed that the second chin implant was done to replace the first one. In his 3D CT scan done to create his custom jawline implant it was seen that there were two chin implants present. An anterior smaller oblong implant sat in front of a larger more standard shaped implant. It appeared that the anterior chin implant was the first chin implant placed given its shape which did not look like any current chin implants.
When placing his custom jawline implant both chin implants were removed. The anterior implant turned out to be of a style I had not seen for over 30 years….a silicone gel chin implant. This is identical to a breast implant as it had as outer shell filled with viscous silicone gel. This type of chin implant was phased out decades ago and replaced with solid silicone implants.
It is interesting to see how the thought process of chin implants has changed over the years. Initially a chin implant was viewed as a soft tissue implant and was not always placed on the bone. Hence why some early chin implants were designed like breast implants and had a silicone gel fill to make them feel more like soft tissue. Today, of course, we know that chin augmentation using an implant is a bone-based procedure. Any efforts at soft tissue chin augmentation are done using injectable fillers or fat.
Dr. Barry Eppley
Indianapolis, Indiana