Cosmetic chin surgery reshapes the chin relative to the rest of the face. Chin enhancement can include bone cutting, but is more often accomplished with facial implants.
In a classically proportioned face, three facial zones are generally considered to be equal in length: the hairline to the brow, the brow to just below the nose and just below the nose to the chin. There are also proportions within the lower face that need to be considered: from the crease of the lip to the chin as well as the relationship between the chin and the neck. These relationships must be considered appropriately to provide the desired outcome.
Proportions of nose to lip, the thickness of the skin around the chin area, and facial expressions, such as smiling and moving your lips are influencing factors as well. Sometimes the whole jawline needs to be increased. This is particularly true in males, where its not desirable to only extend the very tip of the chin. We examine the proportions and musculature of the entire face, at rest and in motion, to determine the procedure that will deliver the best results.
We need to be sure that the function of the jaw and teeth are normal. A very high percentage of patients who ask for chin implants actually have a malocclusion (an imperfect positioning of the teeth when the jaws are closed). Eighty-four percent have what’s called a “Class 2 occlusion,” where the jaw itself is too small, not simply the chin. This type of patient may need orthodontics to improve the relationship of the teeth and even surgery on the jaw itself to move it forward. In some candidates, operations on the jaw should be considered before a chin implant, because a functional problem may require a more surgical solution. If a person does have a normal functioning of the upper and lower jaws and a weak chin, then certainly a chin implant is something to be considered.
Hard silicone is the most frequently used implant material. There are several profiles to choose from, the basic difference is their range in size, from small ones that fit right at the chin, to wide implants that enhance the whole jawline. A chin implant is a relatively short procedure to perform, either through the mouth or through the skin.
OSTEOMY—CUTTING THE BONE
Osteotomy is a surgical procedure whereby the jawbone is cut to shorten or lengthen it, or to change its alignment. This technique is utilized when a simple implant is not going to solve the problem. Osteotomy is appropriate when the length of the jaw needs to be addressed, the chin requires repositioning, or facial asymmetry is to be corrected.
With chin implants, risks include malpositioning, or if the implant fails to stay securely in place. Both result in facial asymmetry. Also of concern are the many nerves that pass through this area that could be damaged, resulting in permanent numbness, but that is not typical. The best way to mitigate these risks is to select a well-qualified and certified plastic surgeon, especially one with cranial-facial training and extensive knowledge and experience with facial anatomy.
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