There are a variety of decisions to be made prior to having a chin augmentation (genioplasty). One of the first decisions to make is the type of anesthesia to have the procedure done under. It is generally a minor enough of a procedure that it can be done under just local anesthesia like going to a dentist, especially if a pre-formed silicone implant is used. In addition, some kind of sedation can be given such as oral medications or intravenous sedation, which provides even more relaxation. General anesthesia is also an option and is commonly used when it is combined with other procedures, such as a Facelift, Blepharoplasty, Necklift or Liposuction of the Neck.
Where to place the incision is also a question. The incision under the chin is short, well hidden and leaves a barely noticeable scar. The one inside the mouth under the lower lip leaves no external scar but may have a higher increase of infection as it is almost impossible to sterilize the inside of the mouth.
There are a variety of implant types, styles and sizes that must be considered. Pre-formed silastic (solid silicone) implants are popular because of their ease of insertion and the fact that they don't require any manipulation by the surgeon. These have a very low infection rate and generally provide a very natural result but they do not become incorporated into the bone like porous implants. These implants require a lot of carving and shaping by the surgeon at the time of surgery.
The amount of projection the implant provides is determined by its size. Your surgeon should help you determine which implant size would be best for you. All of the pre-fabricated silastic implants come in three or four different sizes. They also come in various styles depending on whether the desired end result is to be a broader chin, a narrower chin or one with a cleft. An 8mm implant does not give 8mm of projection when all is healed because the implant erodes slightly to the bone, losing some of the projection and the soft tissue over the implant spreads out due to the tension on the tissue caused by the implant.
Implants can also be positioned just on the front of the chin so that only projection is provided without lengthening the shin in cases where there is adequate height of the lower face. In addition, it can be placed more inferiorly on the jawbone to allow for some increase in the height of the chin while also adding to the projection. Whichever implant is used and wherever it is placed, the greatest change can be visualized from a profile view as this is the best way to see the improvement in chin projection. When viewed from the front, the change is less obvious, which is why many people will not notice this subtle change in ones face.
Patients who are considering chin augmentation are often mostly concerned about the appearance of their chin and neck on profile. It is possible to perform liposuction of the neck at the same time as a chin augmentation through the same incision to improve the neck contour.