Chin augmentation is the term given to any procedure performed to reshape, reduce or enlarge the chin. Procedures include inserting an implant or moving and reshaping the existing bone.
Chin augmentation can be used to rectify asymmetry in the chin area, and also help to achieve overall balance of the facial features.
Why consider chin augmentation?
People can have varied reasons for undergoing chin augmentation procedures. A common reason for some is a concern with the appearance of their facial features. The size of the chin can magnify or minimize the perceived size of the nose. Therefore chin augmentation can help attain a more balanced facial profile.
The proposed chin augmentation procedure can be a standalone procedure or performed in conjunction with other procedures such as jaw surgery.
People undergoing treatment for skeletal discrepancies linked to jaw surgery often have the option of surgery performed on the chin as part of the proposed treatment plan. Once the mandible/maxilla has been repositioned into the correct position the chin point can be off centre. Chin augmentation can rectify this, resulting in a symmetrical chin and a centered chin point.
There are circumstances where there are medical indications for some chin augmentation procedures. The genioplasty/geniopaully procedure results in a more prominent chin which pulls the attachment of the Geniohyoid muscle forwards. This forward movement results in an increase in airway “tenting”, therefore contributing to an improvement in airway volume and breathing.
Chin augmentation can improve the position of the muscle that runs from the chin to the lower lip (mentalis muscle) allowing the lips to meet without straining.
What types of chin augmentation procedures are there?
Chin implants are used to treat people who want to make their chin appear larger. They are traditionally made of silicon. They come in either small, medium or large sizes and are generic in shape, purchased “of the shelf” with no customisation for the individual.
Generic chin implants don’t sit “perfectly” on the surface of the existing chin. This will result in voids between the implant and bone and therefore may increase the risk of infection of the implant. This deficiency in the fit also makes the implant prone to shifting, often seen as a moving chin.
There have also been reports of erosion of the underlying bone due to muscle tension.
As the shape of the chin implant is symmetrical, they will not rectify an asymmetrical chin. They are also not designed to add significant vertical height to the appearance of the chin. As the implant sits on the existing jaw bone the shape of the underlying bone influences how the implant will look.
If a large implant is required it may be difficult to place from within the mouth, therefore an incision may need to be made under the chin. This may result in visible scarring.
If a patient elects to have a chin implant we prefer a customised implant that is made to fit the individual. We use 4D planning to create an implant to address the specific needs of the patient, therefore enabling the correction of asymmetry.
A genioplasty procedure results in the chin being moved forwards to correct a retrusive chin, or sideways to correct asymmetry.
This procedure uses your own jaw bone. It can be used as a standalone procedure to improve the aesthetics of the chin or in conjunction with other types of jaw surgery.
The procedure involves an incision inside the lower lip, the existing chin is then cut and the bone is advanced and secured in position with a small titanium plate. We have modified the traditional genioplasty technique. This new technique we refer to as Geniopaully. We find that it gives better aesthetics and less swelling during the post op phase.
We often use genioplasty / geniopaully after jaw surgery to correct the asymmetry of the chin, or to bring the chin further forward after surgery. We prefer to carry out the procedure after jaw surgery so we can assess how the initial surgery went and be sure that the genioplasty will achieve the best results. The procedure is usually performed at the same time we remove the plates from the jaw surgery.
People who require jaw surgery to correct a receded jaw often have no chin point. Therefore even though jaw surgery has brought the mandible (jaw line) into its “correct position” the chin can still look weak.
Genioplasty brings the chin forward to give this chin point. The same goes for those who have an asymmetry present prior to jaw surgery. Jaw surgery moves the jaw but does not change the shape of the jaw.
The chin point can be moved side to side with genioplasty. Asymmetry of the jawline (further up from the chin point) can be treated with custom jaw implants or contouring of the jaw line.
The main advantage of the genioplasty over a chin implant is that asymmetry can be treated, as can deficiencies in height of the chin. Your own jaw bone is used during the procedure compared with the traditional chin implants which are made of silicon.
Facial implants are used to enhance facial contours. Some common areas where implants are inserted include the cheeks, chin and lower jaw.
We are able to construct custom implants to correct asymmetrical jaw line and chin. These implants are made specifically for the individual using 4D technology. This results is an implant that perfectly fits the existing jaw line and is shaped as per the requirements of each individual case. The client is shown a mock up of the implants and gives their input.
These customised implants are recommended where extensive asymmetry is required to be treated.
Profilo° Surgical designs customised facial implants from a material called PEEK (polyetheretherketone). This material closely matches the strength and density of natural bone, and with time will naturally fuse to the underlying jaw.
PEEK has a proven biocompatibility and biostability, and has a highly accurate fit with the contour of the underlying bone. It can be easily modified during surgery to optimise their final shape and influence on facial aesthetics.
Chin and jaw line recontouring
Ledges in the jaw line that are sometimes an unavoidable result of prior jaw surgery procedures can be recontoured and smoothed off. This is usually done at the same time as plate removal. The jaw line is sculptured with surgical burs.
Small asymmetries can also be treated with recontouring if reducing the area results in an aesthetically acceptable outcome. We do not recommend using this method to treat large asymmetrical discrepancies. This is because there is a limit to how much jaw bone can be removed before the nerve supply to the area is compromised.
We use 4D imaging to plan the procedure.
Which type of chin surgery is for me?
Chin augmentation surgery is not appropriate for everyone. We recommend a consultation to explore all options available to treat the presenting condition. As you can see there are several different procedures to choose from. Chin surgery may not be the only available option to consider.
It is important to diagnose any underlying factors present that have contributed to the aesthetics of the chin area that is of concern. For example a weak looking chin may be the result of a short lower jaw. Bringing the chin forward will not correct the skeletal discrepancy present. It will camouflage it. If there are any symptoms from the short lower jaw these symptoms will still remain after the chin has been brought forward. This is not to say that chin augmentation is not an appropriate treatment option. It is a very good standalone option for those whose concern is only the aesthetics of the chin area. However it is important to know why the chin is retruded so you are informed on all appropriate treatment options. You will then also be aware of any limitations on what the proposed procedure can achieve for you.
If your expectations of what surgical outcomes may be able to be achieved from the surgery are not able to be met the surgery is not for you. There are also medical conditions that may mean chin augmentation or facial implant surgery is not a viable option. These will be discussed at the initial consultation.
What are the risks of chin augmentation surgery?
Possible complication include, but not limited to:
- Numbness/ altered sensation | the nerve supplying sensation to your bottom lower front teeth, gums and lower lip may be bruised or, in rare cases damaged. Numbness is an uncommon side effect and should resolve.
- Infection | Antibiotics are prescribed after surgery to eliminate the risk of infection. We also advise no dairy products to be consumed until the sutures are removed, as plaque (food/bacteria) can adhere to stitches.
- Exposure or irritation of the plates/screws | is rare. These plates and screws are normally removed 3 - 6 months after surgery.
- Aesthetic result is not as expected | this is managed with excellent communication between the surgeon and the patient, and diagnosing any underlying issues that will impact on the end result. It is important to advise the surgeon what your expectations of surgery are so they are able to advise you if these are achievable or not. We use 3D imaging to help plan the procedure so you are given an approximation of the surgical outcome to expect.
- Movement of the implant (non-customised silicon chin implants).
- Difficultly talking or smiling for a few weeks.
- Nausea following the anaesthetic, and other anaesthetic related risks.
Most of these are managed by following the post op instructions as given by the surgeon.
Revisional surgery may be necessary to correct complications.
Recovery after Surgery?
The length of stay in hospital is determined by the procedure and you the patient. We will not send you home until you feel comfortable. A stretched, tight sensation is not uncommon and will quickly settle.
You will have been given a script for medications to fill prior to surgery. Written post op instructions will be sent home with you. It is important to follow these instructions and take medications as prescribed to prevent post op complications.
There is often some pain, swelling and bruising around the lower jaw and chin area. This is controlled with the medications to be taken after surgery.
How long you will be off work/school depends on what procedure you have had. Some people are ready to go back to work the next day, some need several days. A person who has a job that requires heavy manual labour will usually require longer time off work than someone who works at a desk all day.
We generally remove sutures 10 days after surgery. We do not usually use resorbable sutures because they can sometimes take several months to resorb and can get quite irritating. Sutures can be a source of infection due to food residue adhering to them therefore we prefer to ensure they are removed from the surgical site.
Normal activity, except for contact sport, can be resumed about a week after the procedure
Who is a good candidate for Chin Augmentation?
People suitable for Chin Augmentation may include...
- Imbalance in facial features
- Prominent nose
- Inadequate chin projection
People who are not suitable for Chin Augmentation are...
- Anyone with unrealistic expectations
- Anyone with significant facial skeletal abnormalities
- Anyone with major lower jawline deficiencies and asymmetries
- Anyone needing major orthodontic work
‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’