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Chin augmentation

Definition

A chin augmentation is a surgical procedure to reshape or enhance the size of the chin. It may be done either by inserting an implant or by moving or reshaping bones.

Alternative Names

Augmentation mentoplasty; Genioplasty

Description

Surgery may be performed in the surgeon's office, a hospital, or an outpatient clinic.

You will have x-rays taken of your face and chin. The doctor will use these x-rays to determine what part of the chin to operate on.

When you need only an implant to round out the chin:

• You may be under general anesthesia (unconscious and not able to feel pain), or you may receive local numbing medicine along with a medicine that will make you relaxed and sleepy.
• A cut is made, either inside the mouth or outside under the chin. A pocket is created in front of the chin bone and under the muscles, and the implant is placed inside.
• The surgeon may use real bone or fat tissue, or an implant made out of silicone, Teflon, Dacron, or newer biological inserts.
• The implant is usually attached to the bone with sutures or screws.
• Sutures are used to close the surgical cut. When the cut is inside the mouth, the scar is barely visible.

It may also be necessary to move some bones:

• You will likely be under general anesthesia.
• The surgeon will make a cut inside the mouth along the lower gum. This gives the surgeon access to the chin bone.
• The surgeon uses a bone saw or chisel to make a second cut through the jaw bone. The jaw bone is moved to the desired position and wired or screwed in place.
• The cut is closed with stitches and a bandage is applied. Because the surgery is performed inside the mouth, you will not see any scars.
• The procedure takes less than an hour to approximately 3 hours.

Chin augmentation is commonly done at the same time as a nose job (rhinoplasty) or facial liposuction (when fat is removed from under the chin and neck).

Surgery to correct bite problems can be done at the same time as chin surgery.

Why the Procedure Is Performed

Chin augmentation is usually done to balance the face by making the chin longer or bigger compared to the nose. The best candidates for chin augmentation are people with weak or receding chins (microgenia), but who have a normal dental bite.

Before your surgery, discuss your expectations about looking and feeling better with the plastic surgeon. Keep in mind that the desired result is improvement, not perfection.

Risks

The most common complications of chin augmentation are:

• Bruising
• Movement of the implant
• Swelling

Other possible complications include:

• Damage to the teeth
• Loss of sensation

Rare side effects include:

• Blood clots
• Infection that can sometimes require removing the implant
• Pain that does not go away
• Numbness or other changes in skin sensation

Although most patients are happy with the outcome, poor cosmetic results that may require additional surgery include:

• Wounds that do not heal well
• Unpleasant scarring
• Asymmetry of the face
• Fluid that collects under the skin
• Irregular skin shape (contour)

Nicotine from smoking can delay healing.

After the Procedure

You will feel some discomfort and soreness, which you can easily control with medication.

You may feel some numbness in your chin for up to 3 months, and a stretching sensation around your chin for 1 week. Most of the swelling will be gone by 6 weeks, depending on the type of procedure you had.

You might have to stick to a liquid or soft diet for at least a day or two.

You'll probably have the outside bandage removed within a week of surgery. You may be asked to wear a brace while you are sleeping for 4 - 6 weeks.

You can resume light activity the day of surgery. You should be able to return to work and your usual activities within 7 - 10 days. Your doctor or nurse will give you specific instructions.

Outlook (Prognosis)

If the cut was made under the chin, the scar should not be noticeable.

Most implants are good for life. However, implants made from bone or fat tissue that was taken from your body will sometimes be reabsorbed.

Because you may have some swelling for months, you might not see the final appearance of your chin and jaw for 3 - 4 months.

References

McGrath MH. Elective plastic surgical procedures in adolescence. Adolesc Med Clin. 2004;15(3):487-502.

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo: Mosby; 2005:chap 34.