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Chin Augmentation

Chin Augmentation

The goal of chin augmentation is to enhance the contours of the chin, jawline, and neck, and thereby improve overall facial appearance. Chin implants are the most common type of chin augmentation. The placement of synthetic implants around the existing chin bone alters the underlying shape of the face, which enhances the balance of other facial features. Chin augmentation can provide a permanent solution for a recessed chin during an outpatient procedure without using general anesthesia.

WHAT IS CHIN AUGMENTATION?

Chin augmentation surgery, is a plastic surgery procedure that uses either an implant or a patient’s own jaw bone to enlarge the appearance of a “weak” chin and create a better balance among the facial features. When the patient’s own bone is used to enhance the chin the operation is referred to as a sliding genioplasty. Today, there is also the option of using safe silicone implants to provide better chin projection. Although surgery provides a more permanent option to chin projection, FDA-approved hyaluronic acid fillers are commonly used to shape and enhance the chin size. Often times a chin augmentation is done in conjunction with a rhinoplasty to create better overall facial harmony.

NON-SURGICAL CHIN AUGMENTATION

Another method of chin augmentation uses an injectable implant (filler). Most fillers are temporary with results lasting months to years. Common temporary fillers include hyaluronic acid and calcium hydroxyapatite preparations. Permanent fillers, like ‘free’ silicone, have fallen out of favor due to the risk of migration, chronic inflammation, and infection, which can permanently disfigure the chin.

Recommended techniques and procedures for correction of the chin

It is recommended to inject a multiple boluses of the PCL- or CaHA-based soft tissue filler in the subperiosteal area by a 27G needle in the areas near the tuberculum mentalis, in each lateral site. The bolus is then massaged in order to evenly distribute the product over the area. If the results are still not satisfying, then a second bolus (50% less volume than the initial bolus injection volume), should be injected again in the same area. However, the total amount per site should not exceed 0.5cc of product, while usually, 0.25cc per site is enough. Therefore, it can be reasonably assumed that the maximum filler needed is one syringe (1cc), while half of the syringe most likely will be enough in the majority of cases.

SURGICAL CHIN AUGMENTATION

The most common type of surgical chin augmentation uses a chin implant. There are many types of chin implants, and many are described by previous authors. Chin augmentation with a chin implant is usually a cosmetic procedure. An incision is made either under the chin or inside the lower lip sulcus, a pocket is made and the implant placed into the pocket. Some chin implants are fixed to the mandible, while others are held in place by the pocket itself.

Another surgical chin augmentation uses the lower prominence of the mandible as the ‘implant’. Known as a sliding genioplasty, the procedure involves cutting a horseshoe-shaped piece of bone from the lower border of the mandible known as an osteotomy. For chin augmentation, the piece of bone is advanced forward to increase the projection of the chin. The bone can also be recessed backward for a chin reduction. The new position is held in place with a titanium step plate using titanium screws. The bone segment can also be fixated with 26 or 27 gauge wires and inter-maxillary fixation (IMF) (wiring the jaw shut) for three to four weeks. This type of surgery is usually performed by an oral and maxillofacial surgeon or plastic surgeon. More involved orthognathic surgery may be required in cases where a small chin and a significant overbite co-exist. While the procedures above may improve the cosmetic appearance of the chin, they will not improve dental occlusion. Mandibular advancement surgery can be used to correct the alignment of the teeth and improve the projection of the chin.

PROCEDURE

During the chin augmentation procedure, a board certified plastic surgeon will place an alloplastic chin implant underneath the skin around the patient’s existing chin bone. This outpatient surgery typically takes about one hour to perform, does not require the use of general anesthesia, and provides a permanent solution to weak, recessed chins.

The goal of the procedure is to enhance the natural contours of the neck, jaw, and chin in order to improve facial appearance. Chin implants are one of the two main types of chin augmentation. The other is called sliding genioplasty (osseous genioplasty) and does not involve the use of synthetic implants. Instead, the surgeon slides the lower jaw bone forward to produce more lower face and chin projection.

Genioplasty is associated with higher risks for complications that chin implants are. Chin augmentation implants can be placed either through small incisions made inside the mouth or under the chin. Dissolvable sutures are used to close the incisions after the implants are placed appropriately. The typical recovery time for this procedure is 1-3 weeks in most patients.

The goal of a chin augmentation surgery is to restore facial harmony. Chin augmentation can be used to define an underdeveloped chin or give it more prominence. As the shape of the chin is affected by the shape of the nose, chin augmentation is often paired with rhinoplasty.

WHAT TO EXPECT?

Chin implants are a permanent solution for a recessed chin that ofers increased size and projection. Most chin augmentation patients experience relatively little downtime and are back to desk work and most other daily activities within 7 days after surgery. Discomfort is typically minimal and easily controlled with pain medication or cold compresses.

IS CHIN AUGMENTATION RIGHT FOR ME?

Chin augmentation, performed by a skilled and experienced board-certified plastic surgeon, can be one of the most rewarding plastic surgery procedures. Patients often report a significant increase in their self-confidence. Recovery after chin implant surgery is relatively quick.

The best way to determine if chin augmentation is the right option for you is to contact Fattan Polyclinic for a consultation. We will listen to your concerns and goals, examine your chin and facial structures, and help you explore your options.

Typically, patients who get the best results from chin augmentation experience the following concerns:

  • Poor chin definition
  • Small, recessed, or weak chin
  • Ill-proportioned chin size compared to other features
  • Lack of clear contour between the neck and head

RECOVERY NOTES

A chin strap dressing may be placed to keep pressure on the implant and to improve adherence of the soft tissue to the mandible. This is typically removed after 1-3 days. A soft diet may also be advised for 1-7 days. If an intraoral approach is used, peroxide rinses may be prescribed after each meal. Some discomfort, mild pain, swelling, redness and bruising, along with tenderness to touch is expected. Candidates can typically resume normal function within a week.

CHIN AUGMENTATION EXPECTED RESULTS

  • Improved chin proportion with other facial features
  • Decreased appearance of a “double” chin due to a small chin bone
  • Enlargement of a recessed or “weak” chin
  • Better neck and jawline definition
  • Possible decreased appearance of jowls
  • Correction of minor chin and jawline asymmetry