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Facial Implants - Chin Surgery

 

                              Chin Implant - Facial Implants on CosmeticSurgeryForums.com

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  • Genioplasty - Mentoplasty - Chinplasty

The terms Genioplasty and Mentoplasty are used interchangeably to refer to the reshaping of the jaw. Mentoplasty is the technical name for surgery that changes the chin by moving part of the bone forward or augmenting the area with an implant.

Chin augmentation or chin implant surgery is a cosmetic surgery procedure that uses a implant to improve the appearance of the chin area. 

Genioplasty (chin implant) can strengthen the jaw line or build up a receding chin providing balance between the chin and the rest of the face.  Building up a weak jaw line and or to augment a small or receding chin (microgenia) - mentoplasty can be done by either adding an implant or by moving part of the patient's own chin forward in a surgical procedure called a sliding genioplasty.  Patients who have an exceptional small chin sometimes need bone (usually from the hip area) to build up their chin.

 

 

 

This surgical procedure is known as a chin advancement

  • A Sliding Genioplasty is normally performed if the patient's chin is too small for augmentation with an implant - or if the deformity is more complex. 

  • To advance the bone in the chin, the surgeon will make an either make an incision under the lower lip inside the mouth using a power saw which has a special blade to separate the edge of the chin bone - or under the chin in an inconspicuous location so the scar will not be seen.

  • The chin advancement involves removal of part of the chin bone which is shaped like a horseshoe - and slides it backward or forward. 

  • Once the desired place is chosen, the chin bone is fixed into place with positions it with wires or special bone plates and titanium screws. 

  • Finally, the surgeon stitches the incision closed and applies tape to the chin area.

  • The sliding genioplasty is much more costly to perform compared to using an implant, has a much higher incidence of problems, and a longer post-operative recovery period. 

 

 

 

 

                                        How a Sliding Genioplasty is performed

                                            2010 Copyright ADAM, Inc. - Used with permission

 

The mandible and the lower jaw determines much of the facial profile - along with the alignment of the upper and lower teeth.

 

                                        How a Sliding Genioplasty is performed - patient has a bite dysfunction or unbalanced facial profile.

                                         2010 Copyright ADAM, Inc. - Used with permission

 

The facial profile can be balanced by extending the chin in relationship to the nose. Reconstructive genioplasty to correct bite dysfunction can be performed in conjunction with jaw surgery.

 

                                        Incision site for a genioplasty

                                           2010 Copyright ADAM, Inc. - Used with permission

 

One surgical approach is to make an incision inside the mouth along the inferior sulcus (a landmark inside the jaw) to gain access to the chin bone

 

                                        Image showing a osteotomy (bone cut) - bone moved forward and wired into place.

                                        2010 Copyright ADAM, Inc. - Used with permission

 

A surgical incision called a "osteotomy" is made through the jaw bone or (mandible) with a bone saw or chisel.  The lower portion of the separated bone is advanced forward to the new desired position and wired into place.

 

                                                  Osteotomy made through the jaw bone or mandible.

 

Sliding and Fixation:  The bony piece is either moved forward or backwards and secured with titanium mini-plates and screws.  These fixtures are permanent.

 

 

                                        Before and After a sliding genioplasty

                                         2010 Copyright ADAM, Inc. - Used with permission

 

During the recovery there will be some discomfort, however; this is manageable with oral pain medication.  Sometimes the plastic surgeon will recommend a soft or a liquid diet for a couple of days.  Most patients are able to return to work within seven to ten days - depending on the type of work.

 

 

 

 

 

Chin implants are made of a variety of different porous material - such as Gore-Tex, Merselene Mesh, solid silicone and other materials.  Gortex and silicone are two of the most common implants as they have proven to achieve optimum re-contouring in many studies. Those made of silicone are known as "Silastic" implants.

Chin implants come in a variety of shapes and sizes which are customized to the patient and their needs.  The chin or jaw implant will add projection that helps balance the chin with the nose and the neck.  It also can add volume to fill up slack or sagging skin along the jaw line from the aging process.

Chin implant surgery is normally a one time procedure.  With recovery, there will be some swelling and possible discomfort from the procedure.  Oral pain medication is given to handle any discomfort the patient might have.  The swelling can last a couple of weeks.

 

                                                Image of chin implant

                                                  Image of a Chin Implant

 

 

 

Chin implants are inserted through a couple of ways:

  • Chin implants are usually placed through about a two centimeter incision beneath the chin (submental) to conceal the scar.  Through this incision, your surgeon creates a pocket to hold the implant - which resembles a boomerang or a horseshoe-shaped device.  The implant is then carefully placed into this pocket in front of the jawbone. 

  • A chin implant can also be placed through an incision with the lower lip to eliminate the small external scar.  Placement through the lower lip tends to have a higher chance of infection.

 

                                                  Diagram of how a chin implant is placed.

                          Copyright 2010  Pearson Facial Plastic Surgery, P.A. and David C. Pearson, MD.

 

 

 

  • Chin Reduction

With a chin reduction a small incision is made in the natural crease under the shin or inside the mouth area.  The bone is then shaped to the desired size and the incision is closed.  Chin reduction surgery is performed under general anesthesia and takes about one to three hours to perform.

A chin reduction can reduce a protruding chin and improve the facial harmony.

Mentoplasty surgery consists of a surgeon makes an incision in the following locations:

  • under the lower lip inside the mouth

  • under the chin in an inconspicuous location

The surgeon will then use an electrical instrument (a bone burr or a drill) to reduce and reshape the bone to create a more natural appearance. The surgeon will stitch the incision closed and apply tape to the chin area.

Mentoplasty has a higher incidence of nerve damage than does chin augmentation through implants.

 

 

 

 

 

                                   Chin Reduction or Chinplasty - front view        Chin Reduction or Chinplasty - side view

 

The blue area indicates where the bone will be removed during a chin reduction.  If the projection of the chin is too much, the tip of the chin is moved backwards and secured with titanium mini-plates and screws. This procedure is also called a "sliding genioplasty".  These mini-plates and screws are permanent and never are removed.

 

                                                           Sliding genioplasty with permanent titanium plates and screws.

 

 

 

Benefits of Mentoplasty/Genioplasty:

  • A stronger appearance to the chin and profile

  • Reduced an oversized chin

  • Enhances a receding or weak chin

  • Can easily be performed with a rhinoplasty or other facial surgery

  • Multiple chin implant sizes to choose from

  • Intra-oral or direct surgical incisions available

 

 

 

 

An ideal candidate for mentoplasty - genioplasty - or chin reduction

  • An ideal candidate for chin augmentation is a patient without any pre-existing medical conditions.

  • A patient who has a chin that is too small for his or her face.

  • Patients who exhibit patience and stability with the recovery period, as it can take up to three or four months to see the final result.

  • Patient who does not have any emotional problems that would exacerbate post operative depression.

  • The patient has not used Accutane for the last six months before surgery.

  • Patients who have a congenital disorder or facial trauma.

 

 

               Before Chin Implant     Chin Implant Placement      After Chin Implant

                                       2010 Copyright ASPS & ASAPS - Used with permission  

                Before Chin Implant       Chin Implant Placement          After Chin Implant

 

 


 

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