The decision to undergo elective plastic surgery on the chin is a very personal one and is often made at the time of considering other facial changes by an experienced Board Certified Plastic Surgeon like Dr. McMahan
Most patients considering chin implant surgery (augmentation genioplasty) complain of their appearance on profile. They commonly come to their consultation with photographs depicting a side view of their face demonstrating inadequate chin projection resulting in an unbalanced facial profile. A recessed chin compared to the lips or mid-face can make a nose look larger that it really is or give the neck as appearance of fullness with a lack of definition or an attractive aesthetic contouring as it descends from the jaw to the chest.
For some, the motivation for chin augmentation surgery is because the patient feels that a ‘weak’ chin equates to a weak personality or even physical weakness. Others may want their nose to look smaller without undergoing rhinoplasty surgery, which is a more extensive surgical procedure than a genioplasty in general. Adding an implant to increase chin projection can also improve the neck contour whether it is done at the same time as a neck liposuction, neck lift or as an isolated procedure.
There are a variety of shapes, sizes, contours and composition of chin implants available. The most popular is the silastic anatomical implant, which has most of its projection in the front and it gradually tapers out to the side. The back of the implant is contoured to fit the chin and lower jaw. These implants are relatively resistant to infection compared to other more porous implants and rarely move out of position.
The majority of augmentation genioplasties are done as isolated procedures and, therefore, are done under local anesthesia in an office OR setting with or without oral sedation. When combined with other larger procedures such as facelifts or rhinoplasty, they are done under general anesthesia usually at an ambulatory surgery center.
The most popular incision is placed under the chin and is only about half an inch long. The other option is inside the mouth under the lower lip but this can increase the risk of infection. A pocket is created directly on top of the jawbone under a tough layer of tissue known as periosteum, which is the layer of tissue that actually creates bone. The pocket is created by scraping this layer off of the bone and is just larger than the implant to keep it in position. This layer is then closed with sutures as is the subcutaneous tissue and the skin.
A small bandage is generally applied which includes a split tape dressing over the chin that is left in place for three days. There is usually relatively little pain or bruising which can be reduced with elevation and ice. It is best to avoid strenuous activities for about a week and anything that could result in accidental trauma to the chin for at least a month such as playing basketball.