Chin augmentation uses an implant to reshape the chin. This is always in the forward direction for increased fullness. While at one time chin implants were only good at bringing the chin forward, today’s numerous implant styles allow for a long more options in altering chin shape.
One of the most important chin implant improvements is the concept of an extended or anatomic design. Rather than an old-style button chin implant that only brings the central part of the chin forward, the anatomic design has longer wings or sides of the implant that extend further back around the jawline. This allows for a more natural transition between the implant and the jaw bone and any visible step-off is avoided.
While this, in my opinion, is a better chin implant design, its increased curvature and length nay require a longer incision to surgically insert. Also, the longer wings of the implant can be prone to folding and malposition as they are feathery thin and their posterior placement can not be directly visualized.
In my Indianapolis plastic surgery experience, the most common chin implant complication (as few as they are) is lateral wing asymmetry or malposition. Since I routinuely use screw fixation to secure chin implants, I have developed a technique for reducing the risk of extended chin implant malpositioning. After the chin implant is sized, the implant to be used is cut in half down the middle. By so doing, the implant can be inserted as two separate halfs and one side of the long implant is not affected by what the other half of the curvature is doing. The two halfs are then brought together in the middle and separate screws are placed in each half.
This split chin implant technique allows for a very small incision to be used as only half of the implant has to be inserted at one time. Â It is also easier to check that each side of the implant is properly positioned and unfolded to the very end of the created pockets. The screws secure both halfs of the implant and essentially make it function again as a single piece.
Dr. Barry Eppley
Indianapolis, Indiana