Once the patient horizontal chin augmentation needs are determined, the implant style selection is sneeded for chin shaping purposes. Eleven (11) different chin implant styles are available which can be divided into basic (6) and specialty (5) designs. The basic designs are the anatomic, extended anatomic, Conform extended anatomic, Terino extended anatomic, Flowers mandibular glove and chin-prejowl implants. These are the primary chin implants that are going to apply to most chin augmentation patients. Specialty designs are the central, square shaped, vertical lengthening, prejowl and wafer styles.
The basic chin implant styles have different shapes that allow for addressing the non-horizontal dimensional needs of each patient and can be described as follows:
The extended anatomic chin (EAC) implant is the most commonly used and the most versatile. It evolved from the original button-shaped chin implant that looked abnormal and ‘non-anatomic’. By extending the implant behind the chin and further back along the jawline a more gradual transition was achieved that more closely resembled the natural shape of the underlying bone. Such implant extensions will add width to the chin which is usually a desirable feature of chin augmentation in men but not women.
The Conform extended anatomic chin (CEAC) implant is similar to the EAC in shape and sizes. However, its internal surface has a regularly square-shaped grid pattern which provides increased adaption of the implant to the bone’s surface. Because the non-smooth internal surface is created by material removal, it has has a softer feel and will provide less push on the overlying soft tissues than the identical EAC implant size. This is typically used in females who may want a extended wing shape but less risk of too much width.
The Terino extended anatomic chin (TEAC) implant provides a slightly more square shape to the chin but not as strong as that of the square chin implant specialty design. This is best used in men and avoided in women.
The Flowers mandibular glove chin (FMG) implant is an extended style that is distinguished by what it does anteriorly in the central chin. With a higher vertical profile and shape behind the soft tissue pad it provides a more upward tilt to it. This is useful in flatter chin pad profiles in either men or women.
The anatomic chin (ACI) implant style provides pure horizontal augmentation with no width change due to the lack of lateral wings. Most of the time this is considered for use in females where frontally viewed width increases, along with too much horizontal projection, are potential sources of postoperative dissatisfaction.
The mandibular prejowl chin (MPC) implant style has thicker lateral wings to specifically fill in indentations along the jawline right behind the chin. Its original design purpose was in facelift patients who needed horizontal chin projection but also had prejowl depressions as a result of midface soft tissue descent o. Thus it could be considered a ‘facial rejuvenation’ chin implant for older male and female patients.
The wafer chin (WCI) implant is never used by itself as its effects would be too limited. Its purpose is to provide a small amount of additional augmentation to any of the other chin implants when it is intraoperatively determined that a small central horizontal boost would be of aesthetic benefit and to avoid using a new larger implant.
The vast majority of patients are going to be well served by the EAC style with gender preferences for the TEAC (male) and CAEC (female) patients.