Chin implants placed for chin augmentation are one of those procedures in cosmetic surgery of the face, where relatively simple means result in highly satisfied clients. Chin augmentation with chin implants correct the appearance of a chin point “too far back” when the face is viewed in profile from the side. Much like the nose the chin is essential for the appearance of the face in profile view. Unlike the nose right in the center of the face clients however focus less intensely on the appearance of the lower one third of the face, where the looks of the chin play a big role. A well developed chin, in harmony with the entire face, signals determination, strength of character and assertiveness. A weakly developed chin imparts the opposite impression. If this perception, firmly rooted in our minds, is justified, is of course subject to debate. Aesthetics according to Kant’s teachings is the study of value judgements, also when applied to the chin. But be it as it may, you will find few actors, CEOs, news anchors or successful leaders with a weak chin, male and female alike.
What now is the dimension of the problem to which chin implants can be applied ? It really depends on the population one studies. Due to the data generated by Dr. Farkas, a Canadian anthropologist, normative values used to characterize the aesthetics of the craniofacial skeleton are most firmly established for the Caucasians in North America and Afro-Americans. A quite well known rule of thumb from Bell’s book is that ten percent of the population in North America have dentofacial skeletal issues severe enough to justify surgical intervention, be it with orthognathic surgery or corrective placement of facial implants such as chin implants.
In the Caribbean, clients with more diverse ethnic backgrounds present for potential correction with chin implants. In our clinical experience a couple of facts and qualitative trends developed. The number one rule for chin implants, and the only one that counts for you as a client, is that a weak chin is perceived as unattractive across all ethnicities. Very simple, not meriting any further scrutiny. Some examples of the qualitative trends are chin implants to correct a weak chin in our practice are more often placed in Latinas particularly of Mexican descent and East Asians than East Indians, Afro-Caribbeans with weak chins more often than not actually have diminished height and length of the lower jaw bone, etc.
In classic thought the decision for or against placement of chin implants depends on the position of the bony tip of the chin in relation to the rest of the face in profile view. It is measured from X-rays or photographs. The simplest method uses a tangent to the transition between forehead and nose drawn perpendicular to a line connecting the lower margin of the eye sockets with the ear canal, Frankfort’s horizontal. If the tip of the chin is behind that line, placement of chin implants is useful to achieve greater facial harmony. The size of the implant can also be calculated from the distance between this tangent and the tip of the chin. In the Caribbean we not infrequently see clients with midface protrusion, short lower jaws and apparently weak chin with very thick lips. In this situation, the lip-chin line, a line connecting the most protruding points of the upper and lower lip in profile view, tends to be useful to decide for or against the placement of chin implants.
Two basic types of chin implants are available for chin augmentation. They are either made from solid medical grade silicone or PTFE (polytetrafluorethylene), better known under its trademark Gore-Tex. The implants can either be placed through a small incision at the undersurface of the chin or through an equally small incision inside the mouth opposite the front teeth in the lower jaw. Despite the somewhat higher theoretical risk the latter is our preferred method in ethnic clients, who often wish to avoid the small external incision needed otherwise.
Different sizes and shapes of chin implants are commercially available as off the shelf products. The so called extended anatomic implants are our personal favorites. They create a very natural transition on the sides of the lower jaw. The results of chin augmentation with chin implants are apparent immediately after the operation. Swelling, pain and bruising after the procedure are minimal. If an incision inside the mouth was used, soft diet is recommended for a week and brushing of the front teeth must be avoided, rinsing the teeth more frequently instead. Immediately after surgery the lower lip feels stiff and funny due to swelling and healing of the muscles on top of the implant. This has no impact on mouth closure or the ability to move the lower lip, is self limited and disappears over two to three weeks without any intervention whatsoever.
Potential complications resulting from placement of chin implants are few, but not zero. Shifting of the implant in its pocket is the principal aesthetic complication, which we avoid by fixing the implant to the bone with one or two small screws. Chin implants carry a risk of infection, like all implanted foreign bodies. The risk of implant infection is lowest in the face, likely due to the excellent blood supply, the relatively thick soft tissue cover and the prevention of implant mobility by fixing the implants to the underlying skeleton with screws. Infection rates may be lower when chin implants are placed through an external incision and potentially with the use of PTFE instead of silicone implants. The interaction between implant and underlying bone results in a small but measurable resorption of bone and thus over the years to a small decrease of the originally achieved chin augmentation. To date, this has not been a reason for reoperation in our client base, if chin implants were sized, placed and fixed correctly.
Trinidad Institute of Plastic Surgery – the superior choice for chin implants in the Caribbean, Antigua and Barbuda, The Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, Saint Lucia, St. Kitts and Nevis, St. Vincent and the Grenadines, Suriname, Trinidad and Tobago, Bermuda, British Virgin Islands, Cayman Islands, Turks and Caicos Islands, Miami, New York, Toronto, London