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A facelift primarily provides a rejuvenative effect along the neck and jaw line. By removing neck fat, tightening the platysma muscle, and removing excess skin back and up towards the ears, a more defined neck angle is created. Such changes are largely seen in the profile or three-quarter view which is how we are viewed by most other people.

One technique to enhance the change in the neck angle is to lengthen the jaw line at the same time as the facelift. This is most commonly and easily done with a chin implant. By bringing the point of chin projection further forward, the length of the jaw line becomes more pronounced and the neck angle looks even better. It is surprising on photographic analysis how many women are slightly chin deficient by classic profile analysis. When one is younger, a mild chin deficiency adds to a juvenile appearance. When one is older, however, the reverse is true and it makes one look older and more frail.

Placing a chin implant in most facelifts involves no additional incisions. In a full facelift, a submental crease incision is used for the midline neck work. By going north instead of south, the end of the chin bone is easily found. Dissection and implant placement is quick and simple with little extra operative time.

A legitimate concern for many patients is that the fear that the implant may be too big. This can be avoided by doing a preoperative profile prediction analysis . (which is standard in my Indianapolis plastic surgery practice) This not only helps identify whether a chin implant may be beneficial to one’s facelift results but provides a good feel for what size it should be.

Facelifts and chin implants are a common combination for many female facelifts and much less commonly so for men. A slightly stronger chin and defined jaw line creates a more youthful appearance and should be considered as part of the overall facial rejuvenation strategy. Some plastic surgeons debate about what type of chin implant is best to use. I think the material choice is irrelevant as long as the plastic surgeon is familiar with its handling.

Barry L. Eppley, M.D., D.M.D.

Indianapolis, Indiana

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