There are many types of implants that are available for chin augmentation. The two major types of implants that have been used in the market are Gore-Tex and silicone. A few years ago, it was announced that Gore-Tex would no longer be supporting the implant market. Further, Dr. Lam does not prefer Gore-Tex for cheek implants or chin implants since they are difficult to remove and also compress down in size over time. Gore-Tex implants are ideal for the nose but are less suitable for chin augmentation. Accordingly, Dr. Lam exclusively uses a specialized type of silicone implant called a “Conform” style that is very soft and pliable and molds gently to the facial bone so that it is virtually undetectable to touch and to sight. For chin augmentation, Dr. Lam prefers using an extended anatomic implant, which is long and tapered on both sides, rather than the older “button” style implant. The extended anatomic implant provides several advantages over button implants. First and foremost, the extended anatomic implant rarely if ever shifts over ones lifetime, whereas old button style implants oftentimes shifted several years after placement. Secondly, the extended anatomic design provides a more seamless jawline enhancement that can look much more natural and create a better overall aesthetic result, especially in the older individual who may have both a small chin as well as loss of tissue in the area known as the prejowl (the small depression that is noticeable in front of the hanging jowl.)

Dr. Lam will first establish with you what your aesthetic desires are. Because chin augmentation is more easily communicated with a side profile view of your face, digital imaging analysis is an important tool to establish a mutual objective between you and Dr. Lam. The degree of desired projection (i.e., the extent to which the chin protrudes forward) is different based on your facial shape and size as well as your gender. Men can tolerate a slightly larger implant, whereas women benefit from a slightly smaller style implant.After digital imaging analysis is completed, Dr. Lam will use a plastic sizer that gives him a representative size match for the type of implant that would most benefit you. He will also undertake a complete facial and dental analysis to determine your candidacy for chin augmentation. For example, if you have a significant overbite along with dental or TMJ problems, he may refer you first to a dentist, orthodontist, or oro-maxillofacial surgeon for consultation to provide you with all the options during your decision-making process.In addition, a careful evaluation of your neck structures will help determine whether neck liposuction (in a younger patient under 40 years of age) or a face lift (in a patient over 40 years of age) should be combined to achieve the optimal aesthetic benefit in your case. Digital imaging analysis can also be undertaken when appropriate to communicate realistic expectations in neck contouring along with chin augmentation.

Chin augmentation is undertaken usually with general anesthesia in the privacy and safety of Dr. Lam’s on-site surgery center. The procedure itself takes less than 1 hour to perform and you will return to your home that same morning or at the latest by early afternoon.Dr. Lam uses an extraoral technique, i.e., a tiny incision along the crease under the chin for placement of a chin implant for two reasons. This incision, which heals very well, permits improved access for the special type of chin implant that Dr. Lam uses, known as an extended anatomic chin implant (see previous question for details about this type of implant). In addition, this same incision can be used to liposuction and contour the neck as needed.

Like cheek augmentation, chin augmentation can be performed with fat grafting or soft-tissue injectable fillers (like Radiesse, see Dermal Fillers FAQ for more information). However, for someone that is born with a small chin, there is no substitute that can provide as assured a result for chin augmentation than a chin implant. For someone who loses some soft tissue and volume around the chin with aging but was not born with a small chin, fat grafting alone is most likely sufficient to achieve the desired result. For people who are opposed to having implants of any kind other than using one?s own tissue, then fat grafting may be a suitable alternative. It is important to reiterate that fat grafting along the jawline is principally intended to recontour and rejuvenate the lower portion of the face. It is not ideal to achieve a predictable degree of projection (i.e., how much the chin sticks out.)

The recovery following chin augmentation can be quite short. Although the chin will be slightly larger in appearance than the desired augmentation at one week, it oftentimes goes unnoticed. Most patients take several days to a week off from work. If you have any bruising at 5 to 7 days following your procedure, Dr. Lam can reduce and virtually eliminate the bruising with his laser at that juncture. For the first night, you will have a larger bandage around your head, which Dr. Lam will remove the following morning. If you had any neck liposuction or facelifting performed simultaneously, then a light supportive neck wrap should be worn for the remainder of the week. Men should avoid shaving around the incision line for the first two weeks and use only an electric razor for the following two weeks. Skin sutures are removed 10 days after the procedure.

In most cases, you should be quite satisfied with your result. However, if the implant is too small, an additional “wafer” can be added behind the implant to achieve the desired look as an office-based procedure. If it is too large, it can oftentimes be shaved down to the appropriate size. Depending on the implant style, this can be done as an office-based procedure or with light sedation in the operating room.