There are numerous options available to patients who are considering chin augmentation surgery. The type of surgery to augment the chin, whether or not an implant is used, the type of implant, its size and the placement of the scar are all options with augmentation genioplasty.
Type of Genioplasty
The first option is whether to put in a prosthetic implant or to undergo a procedure where the bone is cut, repositioned in a more forward position and held in place with wires or plates and screws. This is a more involved surgery but does not require insertion of a prosthetic implant. Many patients who undergo this type on surgery, known as a sliding genioplasty, also have malocclusion issues and will combine the chin surgery with a procedure to re-align the upper and lower jaw; known as orthognathic surgery.
When it comes to inserting an implant to augment the chin, there are a variety of options as far as what is inserted. The two most common implants are firm silicone rubber (silastic) and more rigid biocompatible materials such as Medpor. The former is a prefabricated implant that does not generally require modification by the surgeon while the latter comes in a block, which is carved and contoured by the surgeon prior to insertion.
The prefabricated silastic implants come in a variety of shapes and sizes to choose from. The size of the implant is mostly determined how much projection one desired in the implant but also affects the width of the implant. Most of these implants gradually taper out to the side so that there is not a sudden drop off where the implant stops, therefore, the larger the implant, the farther it extends to the side along the lower portion of the jaw bone.
Other options with the prefabricated implants include different shapes that are designed not only to enhance the size of the chin, but also to alter the shape. Some are created to make the chin either wider or more pointed and there are also implants designed more for men who want a cleft in their chin.
The size of the implant obviously determines the amount of projection that is obtained with augmentation genioplasty surgery. Most of the prefabricated silastic implants come in four sizes with the smallest resulting in a very subtle change and the largest creating a drastic difference in the projection of the chin. The middle two sizes are the most commonly used in chin enhancement surgery.
One final option with prefabricated implants is the position of the incision for inserting the implant. These can be placed either through an incision inside of the mouth below the lower lip or through a small incision positioned just below the chin. The intraoral approach has a little higher risk of injection because of the bacteria found in the mouth; therefore, the submental route is generally the preferred method for inserting chin implants.