It is not unusual that during consultation for a rhinoplasty, the surgeon will recommend correction of a receding chin. This occurs because the facial surgeon does not consider the nose as an isolated feature, but rather as a part of the entire face. In evaluating the aesthetic proportions of the face, I think in terms of the best possible profile obtainable for the individual patient.
If only a nasal plastic procedure is completed, and if the chin is too weak and the forehead is slanting, the facial features will tend to be pointed with the focus at the nose. In fact, I may advise against any nasal procedure unless projection of the chin is increased at the time of rhinoplasty.
In general, when looking at one’s profile in the mirror, the chin should approximate the imaginary vertical line drop from the edge of the lower lip. Many patients desiring rhinoplasty are unaware that their chin is small or out of balance with the rest of their face. Of course, there are individuals who require chin augmentation, but also have no need for rhinoplasty surgery.
Occasionally, I will recommend consultation with an oral surgeon who is trained to align the whole jaw and teeth. It may be that more is required than simply augmenting the chin.
The material used to build up the chin is a medical-grade synthetic implant, of either solid or mesh variety. This implant is used to increase the skin projection by supporting the soft tissue overlying the mandible (lower chin/jaw bone). This type of material has been widely accepted by surgeons because of its years of proven success and safety in repairing heart valves, grafting arteries, etc. Within a short period of time following surgery, the implant becomes incorporated into the tissues and acquires nearly the same consistency as the surrounding tissues.
For a majority of patients, the surgery is performed under the “twilight” anesthesia, which has been described in an earlier section of this booklet.
Normally, I place the implant from inside the mouth. However, when the submental fat removal or double chin procedure is performed at the same time, the implant may be placed from an incision well hidden under the chin.
Alternatively, some patients are better served by the performance of a genioplasty. In this procedure, a small portion of the chin is advanced forward and secured in place. The genioplasty procedure is similar to chin augmentation, without the use of an implant.
After surgery, a dressing may be placed around the chin, overlying some tape, until the morning following surgery. At that time, the dressing is removed and the tape remains in place for one week.
In chin augmentation, as in any surgery, such elements as infection, rejection of the implant, paresthesias (sensations of prickling, tingling or creeping of the skin), and swelling can occur, and a patient must be willing to accept these risks. However, the procedure carries a very high rate of success and adds the finishing touch in reconstructing facial harmony. The results are often dramatic and very gratifying for the patient.
In addition to reading this section, I recommend patients read the sections on nasal reconstruction and submentoplasty. The latter procedure, sometimes done at the same time as the chin augmentation surgery, often lengthens a short neckline.
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- Immediate-Past President of the American Academy of Facial Plastic and Reconstructive Surgery
- 30+ Years of Experience
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