Articles
Chin Augmentation
Chin augmentation is a procedure to balance the facial structure in width and projection. This is often most evident in a profile view. Soft or weak chins, sagging skin and witches deformity can be corrected.
Procedures are done in isolation or in combination with nose surgery, face or neck surgery, neck liposuction and cheek or lip augmentation.
Ideally the person should be in good health. A history of scar tendency, medications, blood thinners and herbal supplements is part of the assessment. Poor scar tendency may be overcome by siting the incision within the mouth.
Augmentation can be non surgical or surgical. Non-surgical techniques used fillers or fat to enhance the chin profile. By selecting the more viscous fillers and placing them in a deeper plane, the longevity of the product is increased. This is a short procedure completed in the rooms. Sedation is not usually required. Some practitioners have nitrous oxide or happy gas available.
Conventional fat transfer techniques can achieve similar results. Once stable the fat is usually permanent.
Surgical techniques can be either onlay or bone moving. Onlay techniques include using silicone, polyethylene or bone grafts. Bone moving involves surgically cutting the lower chin bone. This bone fragment can be moved forward and then fixed in a more desirable position. Small screws securely hold the fragment to ensure accurate healing. This is also known as a sliding genioplasty.
Surgery is usually a day only procedure and performed in a day surgery or hospital. Depending on the technique it can be performed with sedation or a light general anaesthetic. Local anaesthetic containing adrenaline is used. The adrenaline reduces bleeding and bruising by causing the blood vessels to shut down. Because the local anaesthetic reduces the pain the amount of general anaesthetic required is reduced. The local also ensures a number of pain free hours after the procedure.
Incisions are either placed in the mouth or under the chin. Within the mouth leaves no external scar. The risk of infection is theoretically slightly higher. Placing the incision under the chin attempts to conceal or hide the scar. From these incisions a pocket is dissected to accommodate the implant.
Silicone prostheses are carefully measured for accurate width and thickness augmentation. Extended implants conceal the edge of the implants. The silicone is solid, durable, textured and can be stitched to limit movement. These implants are also easily removed from the pocket.
Polyethylene implants are firmer, harder and porous. This allows tissue ingrowth which reduces the risk of displacement but makes removal more difficult. Both of these can cause underlying bone resorption.
Bone grafts can be fixed to the chin for augmentation. Bone is taken from another site in the body and fixed with small screws to the chin. It then heals similar to a broken bone or fracture. Bone grafts can resorb to a variable degree. There is also a distant scar or donor site from where the bone was taken.
With all these techniques the results are immediate.
After surgery the chin is strapped and taped. This helps hold the implant in place and reduces swelling. A soft or liquid diet is recommended. If an incision in the mouth is used, mouthwashes after eating are prescribed. Antibiotics and analgesia are also used. There is usually some discomfort. Bruising is rare.
Complications include infection, movement or displacement, bleeding, asymmetry and wound healing problems. Temporary disturbance of speech and numbness may also occur. Despite this list the procedure is usually very well tolerated. Recovery is rapid with a return to work and exercise in a few days.
Results obtained are very favourable in those with realistic expectations. It is a safe and commonly performed procedure.
The Fast Facts Box
Cost: $2000-$6000
Time in hospital: 60-120 minutes