Aesthetic chin augmentation is a facial plastic surgery procedure to reshape or increase the size of the chin for better projection and appearance. It can balance a facial profile by extending the chin in relation to the nose. Patients with a relatively normal dental bite, but weak or receding chins, are the best candidates for chin augmentation.
There are two basic approaches to chin augmentation. In some cases, it may be best to move the chin bone forward. In this technique, called genioplasty, the surgeon makes an incision inside the mouth to gain access to the chin bone area. Using surgical instruments, a horizontal cut is made through the bone. The lower portion of the separated bone is then shifted forward and stabilized. Because surgery is performed through an internal incision, the patient has no visible scar. When a modest degree of chin augmentation is required to provide contour, the surgeon may recommend a chin implant or prosthesis as an alternative. Often a chin implant is made of a solid type of silicone (not the jelly type that was at the center of controversy in the breast implant issue). Implants now include extensions that are more anatomically natural. With this technique, an incision is made either inside the mouth or externally on the underside of the chin. Working through the incision, the surgeon creates a pocket above the chin bone and under the muscles to insert an appropriately-sized chin implant. The key to the surgery is to make a precise pocket. The scar from an external incision, made in the chin crease, is negligible. I definitely prefer to approach the surgical site from the underside of the chin with an external incision, avoiding the muscles that run between the inside of the mouth and the edge of the chin. It is remotely possible to detach the chin muscles from the bone through the intraoral approach, and this is extremely difficult to correct. However, both approaches are certainly acceptable. The main consideration is your surgeon’s comfort level with the preferred technique. A chin implant is done along with nose surgery perhaps 10 percent of the time because a recessive chin accentuates a large nose. If facial balance is established, a proportional chin automatically gives the illusion that the nose is smaller.
Some soreness and discomfort, which is easily controlled by pain medication, will occur after surgery. I advise a liquid diet for a week. Patients usually are up and around the same day and may go back to work and normal activities within a day or two if they do not object to wearing the dressings and chin strap in public. I have patients keep the Steri-Strip adhesive skin closures used in this procedure on for about one week. It is normal to feel a little depressed after any surgical procedure. This should pass in a few days.
Risks and Limitations
Risks can include infection, bone reabsorption, chin numbness, displacement, extrusion, asymmetry, and bleeding. As always, the patient may be dissatisfied and surgery to revise the procedure may be needed. I have had several implants migrate toward the mouth, and the patients could feel them with their tongues or when chewing. I corrected this by reentering the pockets and lowering the implants. I now suture through the implant and the lining of the bone to keep it in a more stable position. Another potential problem is chin drop, or “witch’s chin.” The fleshy chin pad we all have is attached directly to the chin bone. If these attachments are interrupted by surgery, then the chin tissue could droop downward. This rare deformity only occurs when the original implant is placed through the mouth. If you would like to learn more about plastic surgery in St. Paul or Minneapolis, feel free to contact our practice for a consultation!