Genioplasty & Mentoplasty hr

For many patients, the chin is a focus of concern in photographs and at conversational distance. Chin augmentation may increase the prominence of one’s chin in accordance with other facial features and enhance definition of the lower face.

hr

What is Chin Augmentation Surgery?

Chin augmentation is a surgical procedure to augment a recessive chin. It may also sharpen the angle between the chin and neck for further definition. Chin augmentation may alter the size and shape of the chin in all dimensions: height, width, and projection. It may also be performed to reduce the appearance of a dimpled chin.

Chin augmentation is performed as outpatient surgery most commonly under general anesthetic to ensure maximum patient comfort and safety. Patients may generally be able to return to office-based work or school within a week of surgery.

hr

What are procedure options for chin augmentation?

Chin augmentation may be performed using an implant vs. autologous tissue. Chin implants are most commonly made of silicone vs. porous polyethylene. The implants come in different sizes and may be altered intra-operatively to fit appropriately in an individual patient. The implant is placed through an incision in the submental crease (under the chin) most commonly, which is generally well-concealed once fully healed. Although it is possible to place the implant through an intraoral approach (through an incision inside the mouth), this exposure is more difficult for precise implant placement and carries higher risk of infection given that the intraoral region is a contaminated site.

Fat grafting is an option for chin augmentation using entirely autologous tissue. This avoids the need for an implant. During fat grafting, fat is harvested from a distant body site (most commonly the abdomen or thigh) through small volume liposuction. The fat removal is performed by hand suction to minimize risk of injury to the fat cells during harvest, which may increase the likelihood of the fat surviving the transfer process and reestablishing a blood supply at the new site. The fat is carefully prepared and then injected in the chin region through very small access incisions. Overcorrection is generally performed to account for partial resorption. Not all fat will survive the fat transfer process and overcorrection by 30% is often performed. The aesthetic outcome at 6 months post-operatively is generally stable. Further resorption should not occur beyond this stage and results may be long-lasting.

hr

Who is a candidate for chin augmentation?

A candidate for chin augmentation is otherwise healthy and does not have any contraindications to undergoing elective cosmetic surgery. It is important to be a non-smoker or to achieve smoking cessation for at least one month pre- and post-operatively. This pertains to patients undergoing either implant reconstruction or fat grafting. It is a serious complication if a chin implant becomes infected since it is a foreign body. Smoking cessation is also important for patients undergoing fat grafting since the injected fat must reestablish a new blood supply. This may be negatively affected by smoking. As with any elective cosmetic surgery, a candidate for chin augmentation should have realistic goals and be able to comply with post-operative instructions and activity modifications. Recommended activity restrictions are intended to lower the risk of post-operative complications. Exercise should be avoided for one month to lower the risk of bleeding, bruising, and further swelling. Following chin augmentation with autologous fat grafting, massage will be recommended during early follow up when considered medically appropriate. This will help to desensitize the region and expedite scar maturation. It is also performed to soften any small areas of nodularity that may develop following fat injections. Patients interested in chin augmentation using fat injections must also have adequate body stores to harvest fat for injection in the chin region. A small volume of fat is generally required and most commonly harvested from the abdomen or thigh.

hr

What are risks and benefits of chin augmentation?

Chin augmentation may enhance chin prominence and change the shape of one’s chin to achieve balance with other facial features. It may be combined with other facial procedures to alter one’s profile view. The position of the chin is an important clinical consideration for patients considering rhinoplasty.

Risks of chin augmentation include bleeding, hematoma, infection, asymmetry, and wound healing complications. There is also risk of injury to surrounding structures during chin augmentation, which may result in lower lip numbness or muscle weakness. The majority of these cases are temporary with very low risk of permanent nerve injury following chin augmentation.

Risk of infection is particularly concerning for an implant reconstruction given that the implant is a foreign body. An infected implant that either does not respond to or is not suitable for antibiotic treatment may require temporary removal in extreme cases. This would ensure that the infection has cleared prior to any further surgery. Candidates for chin augmentation are carefully selected to ensure low risk of infection. Smoking cessation is very important prior to implant surgery.

A chin implant may also shift or become encapsulated in tight scar tissue, which could result in asymmetry or secondary aesthetic complications. Chin augmentation through fat transfer also carries risk of donor site complications (where the fat is harvested from) as well as risk of resorption, over- or undercorrection, or fat necrosis, which may result in regions of nodularity.

hr

Chin Augmentation FAQ

What is recovery after chin augmentation?

Patients are generally able to return to work or school within one week of surgery, however should refrain from strenuous activity for one month post-operatively. Refraining from exercise is important to lower the risk of healing complications, particularly bleeding, bruising, and increased swelling. Pain medication may be required for a few days following chin augmentation. Cold compresses are important over the first 48 hours following surgery to lower swelling and to reduce discomfort.

How is chin augmentation performed?

The technique of chin augmentation best suited for your aesthetic goals and clinical presentation will be discussed during consultation. Fat grafting is an option to enhance the chin using natural body tissues. It avoids the need for an implant. For patients seeking more pronounced chin augmentation or for those without adequate fat stores, implant reconstruction may be performed, most commonly using a silastic implant.

Are results permanent after chin augmentation?

An implant leads to permanent augmentation in terms of volume. The appearance of the implant may change over time due to capsular contracture (tight scar tissue that forms around a silastic implant) or implant shifting. Chin augmentation results after fat grafting may be long-lasting once the injected fat has reestablished a new blood supply. Augmentation is initially overcorrected during fat transfer to account for partial fat resorption over time. Once the fat has become revascularized, the results should be permanent.

May chin augmentation be combined with other cosmetic surgeries?

It may be possible to combine chin augmentation with other surgeries. Rhinoplasty and chin augmentation may be combined to enhance one’s profile and to achieve facial balance. Chin augmentation may also be performed during facelift surgery to enhance chin definition and to further sharpen the cervicomental angle (definition between the neck and chin regions).

What type of anesthetic is used for chin augmentation?

General anesthetic is most commonly performed for chin augmentation, particularly when combined with other cosmetic procedures. It ensures maximum patient comfort and safety during the procedure. Chin augmentation is performed as outpatient surgery unless combined with a longer cosmetic procedure necessitating an overnight stay.

Is there scarring after chin augmentation?

For an implant reconstruction, a small scar is most commonly placed under the chin in the submental crease. This scar is well-hidden in a relaxed skin tension line. Although intraoral placement does not leave an external scar, there is greater risk of infection when placing the implant through the mouth and it is not commonly recommended.

When are stitches removed following chin augmentation?

Resorbable (dissolving) sutures are most commonly placed during chin augmentation surgery, which do not require removal.

When are follow up visits scheduled after chin augmentation?

The first follow up appointment is generally at one week post-operatively to assess early healing as bruising and swelling begin to settle. Follow up at 4-6 weeks post-operatively is performed to assess early results, followed by visits at 6 months and then at one year. If concerns arise patients are certainly welcome back in the office at any time, however more frequent follow up visits are not routinely scheduled.

The appropriate technique for chin augmentation will be discussed in consultation and will depend on each patient’s unique presentation, surgical goals, and preferences. Chin augmentation may enhance the definition of one’s lower face and enhance one’s profile to augment a recessive chin.

Please contact us to schedule your consultation.