There are basically two approaches to putting in a chin implant when performing chin enlargement surgery or augmentation genioplasty. The first is through an incision inside of the mouth under the lower lip; the other is through a small incision through the skin under the chin.
Both approaches have their advantages and disadvantages. Putting the implant in through the incision inside of the mouth below the lip has the advantage of not leaving an external scar. The tradeoff, however, is a somewhat higher risk of infection simply because the mouth has a much higher concentration of bacteria in it that the skin does and it is virtually impossible to ‘sterilize’ the oral lining with the prep solutions before surgery.
Placing it via the incision under the chin has a lower risk of infection, which is a risk with any type of surgery but is a higher risk when a foreign body or implant is inserted. The tradeoff here is a scar in the skin that, fortunately is quite short and typically heals as a very fine line.
Regardless of the approach, a pocket is created for the implant directly on the jawbone after the tough layer next to the bone (periosteum) is elevated. This pocket is designed to be just slightly larger than the implant so that it sits in the pocket comfortably but with very little room for it to move around. It is common to ‘test’ the pocket by first inserting implant sizers which are identical to the implant and are inserted to see how well the pocket was created and what effect different size implants will have.
There are two basic types of implants. One is a prefabricated silastic implant made of solid silicone. The other is a porous block of material that must be carved at the time of surgery and must be secured to the jawbone with wires or screws. My preference is the former implant because of fewer complications and a more predictable result.
After the proper implant is chosen, the tissue is closed in layers with sutures. A small dressing is applied and it is common then to place a split piece of foam tape over the chin to immobilize the implant in the pocket for three to four days. It is helpful to keep your head elevated for several days and to use ice packs for two to three days to reduce swelling. Sutures are typically removed in five to seven days.
It is important to follow all instructions carefully to reduce the risk of complications and to get the best result possible. After surgery for two to three weeks, no strenuous activity should be performed as this can increase bleeding and swelling and it can delay the overall recovery. Any activity that can result in trauma to the jaw area should be strictly avoided for six weeks as a direct blow to the chin could result in displacement of the implant out of position.