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جراحی چانه

Chin surgery (mentoplasty or genioplasty) and solutions for chin augmentation

Today, cosmetic surgeons and technicians, who work in the field of facial beauty, all believe that having a chin proportional to the facial elements is regarded as one of the most important factors affecting a beautiful face fit. In this article, we will talk about chin augmentation and the solutions for chin augmentation, such as chin surgery and prosthetic implantation.

Chin Augmentation

Research shows many people who are dissatisfied with their noses’ size and shape, or those with sagging muscles in the area of a double chin pay no attention to the small size of their chin (microgenia). This is while a small chin causes the nose to look more prominent or the drooping in the double chin area to stand out more.

Today, with the advancement of science and technology in the field of medicine, there are many surgical and non-surgical techniques to correct the shape of the chin and beautify it.

Sometimes this question comes to mind: Is the chin beauty criterion the same for women and men?

We should say “No” in response to this question. The chin is different in men and women. For example, in the full-face view, male chins are wider in width, while female chins have less width. In the profile view, male chins appear more prominent and elongated as compared with the female chins.

What are the solutions for chin correction?

Using chin prosthesis is one of the best solutions for chin correction. In the following, we will investigate the solutions for chin correction.

Chin Augmentation

Chin prosthesis

Chin prosthesis is used for chin augmentation (in chin surgery or chin cosmetic surgery) and is available in different shapes and sizes. It is made of materials that are compatible with the natural tissues of the body and can remain in the body for a long time or forever.

Chin prosthesis applications

Perhaps chin prosthesis is the best solution for people whose face does not fit due to small chin structures, and the lower face and upper face do not fit together. In the absence of facial proportion in the upper and lower face, the beauty of other parts of the face will not be seen much. Beautiful lips besides a small chin fail to show their attractiveness and this holds also true for the nose and other parts of the face and neck. In such a situation, we can correct this inconsistency via chin augmentation (chin surgery/chin cosmetic surgery) and we can beautifully exhibit other facial elements besides beautifying the chin.

The use of chin prosthesis is one of the most common methods for chin augmentation.

Among other important applications of chin prosthesis that are used less in Iran is the rejuvenation of the lower face. As we age, the chin, especially the tissues surrounding it become smaller in size and volume. The insertion of prosthesis in this site returns the lost volume and rejuvenates the face.

Are there alternative ways to augment the chin if I don’t want to use a chin prosthesis?

Yes, there are non-invasive and, of course, with less durability methods, including:

First method: Gel injection or fat injection

Through gel injection or fat injection, we can augment the chin to some extent and partly correct a receding chin (retrogenia). This method is a proper choice for people who require minor changes in the chin area and causes the chin to look more beautiful. Considering the gel nature, the gel shaping is more feasible than fat shaping, and using gel, a better chin shape can be created.

Second method: Changing the shape of the chin skeleton

In this method, the person’s chin bone is broken via surgery. The chin can then be pushed forward or set back. This method was more common in the past, and it was regarded as a difficult surgery due to breaking and shaving the bone. As the recovery period is long, this method is less used today.

Nowadays, most physicians recommend the use of chin prosthesis instead of this technique for the following reasons:

·       Higher safety

·       Shorter recovery period

Using prosthesis, the chin asymmetry risk can be reduced to a large extent. Even in some cases, the physician can partly attenuate the chin asymmetries by properly shaving the prosthesis and inserting it in the proper place (the asymmetries can never be completely eliminated, but they can be attenuated using some techniques).

Third method: Jaw implant surgery

This method is suitable for people with a receding chin and very small lower jaw whose teeth do not fit together properly. If a person also suffers from the problem of snoring, his snoring will reduce using this method, while the use of chin prosthesis cannot reduce snoring.

jaw surgery

In general, few people are willing to undergo this surgery as it is a difficult surgery with a long recovery period and high cost as compared with other methods.

chin augmentation

In this picture, you see a person who has lost the standard form of his/her chin due to the posterior position of the chin. The receding chin has led to a double chin as well. The double chin in this person is not the result of being overweight. The chin shape correction through chin prosthesis placement has corrected both the chin shape and the double chin.

Different methods of chin surgery and their differences

Chin prosthesis can be inserted from inside the mouth or below the chin. The chin surgical incision is made on the inside of the mouth behind the lower lip in the intraoral method. Considering the important advantages of this method, it can be said that the incisions are not visible as they are made on the inside of the mouth. Sometimes, some of the patients prefer this method. In this method, the chin (mentalis) muscle must be incised to get access to the place where the prosthesis is inserted.

Although this muscle is repaired using special stitches following the surgery, it will not be like a natural muscle and will change the shape of the lower lip over time. Moreover, the chin sensory nerve (mental nerve) is more likely to be damaged in the intraoral method. People who experience numbness in the lower lip after the prosthesis placement fall under this category. On the other hand, the possibility of shaving and shaping the installed prosthesis will be limited due to the surgeon’s small visual field.

how to implant a chin prosthesis

Chin prosthesis installation from the outside (through an incision beneath the chin) provides the surgeon with a very proper vision to be able to choose the suitable site for prosthesis placement to achieve the desired shape. Additionally, the submental fullness can be corrected at the same time as the fat accumulated under the chin is removed in people with a double chin.

Chin prosthesis (chin surgery-chin cosmetic surgery) can be installed using screw or suture fixation. On the other hand, if the prosthesis installation site is not opened too much by the surgeon, the prosthesis can be left freely in situ without any screw or suture, but the possibility of the prosthesis displacement is very high in this case.

Fixing the prosthesis using screws helps us prevent the prosthesis from displacing. Moreover, the asymmetry in asymmetrical chins (chins with asymmetry before surgery) can be reduced by shaving the prosthesis. The experience has shown that performing this surgical method has been accompanied by good results.

 In the following picture, you can see an instance of chin prosthesis surgery and its final result.

chin prosthesis before after

Who are not the right candidates for a china prosthesis?

People who are looking for minor changes in their chin area (at most 3 mm) are recommended to use non-surgical methods to correct their chin shape because the smallest prosthesis available is about 3 mm and (currently) there is no prosthesis smaller than this size. Therefore, people who are seeking changes less than 3 mm had better use non-surgical methods for chin correction.

 Important parameters for chin prosthesis selection

When choosing chin prosthesis, most people only think about one dimension, i.e., the chin projecting forward (increasing projection), however, to have a beautiful chin a 3-dimensional change in the chin should be made. Therefore, be sure to consider the chin width in the full face view. If the chin width is appropriate, then the edge of the lower jaw is shown smooth and aligned (a state seen in a young person). Moreover, it greatly helps with the beauty of the jaw angle. Failure to pay attention to this issue can cause the beauty of the lower face to be less visible despite the chin projection.

The other important thing to be considered is the dimensions of the lateral arms of the chin prosthesis. Choosing the right length of prosthesis’ arms can significantly affect the chin shape determination. Old prostheses were designed in a way that they had short length arms and augmented the chin only in the frontal part. They deprived the user of other advantages of this surgery.

Of course, the old chin prostheses are still used in some persons, but they are not of use in most clients because their usage causes dimples to appear in the areas around the chin. This state is observed more in the elderly.

 The proper use of prostheses with long arms allows the surgeon to fill the dimples around the chin after the placement of the chin prosthesis (chin cosmetic surgery). This way, in addition to projecting the chin forward, the lower face (the area around chin and lips) is rejuvenated.

Is the surgery applicant’s gender considered in the selection of the proper prosthesis given chin differences in men and women?

In response to this question, we should say that there are no male and female chin prostheses and they can be used for both genders. However, there are different types of chin prostheses in terms of shape and size.

Considering the gender of the surgery applicants, anatomy of their face, and chin shape, the surgeon machines the prosthesis and gives the required and desirable shape to the chin to not only beautify it, but also causes the other facial elements to completely fit together. We should notice that not all prostheses can be machined and changed.

The long-term effect of chin prosthesis material

The positive aesthetic changes that accompany chin cosmetic surgery are the same in the short term (less than one to two years) for all prostheses used. However, the long-term results of prostheses differ from each other to some extent. The compatibility of the chin prosthesis with the body and the changes that occur around the prosthesis over time can significantly affect the long-term results.

Polyethylene prostheses

Among the prostheses, polyethylene prosthesis or (porous polyethylene chin implant) with the commercial name of “Medpor” has the ability to be machined, and depending on the applicant’s gender, the appropriate width can be created.

Polyethylene prostheses

Silicone prostheses

This type of prostheses has a smooth surface and causes a capsule to be formed around them when they are placed on the bone; however, they lead to the adjacent bone erosion and absorption over time. This can push the bone backward after some years. That is why the chin looks better in the first months as compared with some years later. Moreover, the risk of infection is a little higher in silicone prosthesis (of course facial prostheses are rarely infected). In contrast to this category of prostheses (silicone, teflon, etc.)

there is the porous polyethylene prosthesis (Medpur) with many cavities like a sponge. The presence of these cavities prevents the formation of a capsule around the prosthesis, and even causes tissue growth in these cavities. The other advantage of this type of prosthesis is that it does not cause any corrosion on the underlying bones. Therefore, not only the results of these prostheses are stable in the long term, but also they appear to have a lower risk of infection than other types of prostheses. However, this type of prosthesis is used less for two main reasons:

  • The cost of this prosthesis is higher than other types.
  • This prosthesis installation and shaving requireshigh accuracy and only surgeons who are very skillful in these prostheses installation can attain desirable results.

Note that the short-term results of the chin prosthesis are the same in all types of prostheses. The main difference is observed in the long-term results.

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