| Dr. Vishal Banthia is a plastic surgeon certified by the American Board of Plastic Surgery. Here the Doctor has answered some of the common questions Bizymoms visitors have about Chin Implant.
Q. What will a chin implant do for me?
The most common indication for a chin implant is the presence of an underprojected, or ‘weak,’ chin. For some, a weakly projected chin can confer an image associated with a lack of confidence whereas a strongly projected chin connotes power. If one looks at the comic book drawings of superheroes (i.e. Superman), one can easily see that many of the superheroes have square jaws and strongly projected chin structures. Some people are born with an underprojected chin, but we all lose chin projection with time. With the aging process, there is loss of anterior projection of the chin and vertical height due to bony and soft tissue absorption and atrophy along the jaw area. Placing a chin implant is an extremely safe, powerful, and gratifying procedure for both patient and surgeon alike. Elegant and eye-pleasing facial balance and harmony can be attained by augmenting the chin area. At Réviance, we augment the chin area either by placing a chin implant (usually a semi-solid material typically made of a silastic polymer) along the lower border of the mandible (jawbone) or by the use of fillers.
At Réviance, we perform chin implants either as a stand-alone procedure or in conjunction with facelift and/or neck contouring procedures. The placement of a chin implant immediately improves the appearance of the jaw area as well as the neck area, especially in those patients who are candidates for facelift and neck contouring procedures.
I perform chin implant procedures under local anesthesia within 30 minutes. I place the implant either through a small incision inside the lower lip area in the mouth or through a small incision just under the chin area. This incision heals very nicely. Downtime and post-operative discomfort is minimal; patients who have a chin implant as a stand-alone procedure usually return to work within a few days.
Q. What is a prejowl implant?
Atrophy of soft tissue in the area between the central chin and adjacent jowl area along with bone resorption of the jawbone in this area result in a groove on each side of the central chin known as the prejowl sulcus. This prejowl area is associated with what is commonly known as the "marionette lines" or "drool lines."
Chin implants come in a variety of shapes and sizes. A prejowl implant is a type of chin implant that augments the prejowl sulcus but does not augment this central chin area. There are also chin implants that augment both the chin as well as the prejowl area. By augmenting this prejowl area, a more youthful appearance is achieved as the degree of jowling is lessened. Chin implants that augment the prejowl area are particularly effective in the common facelift patient as these patients frequently have a deep prejowl sulcus. A careful preoperative evaluation by the surgeon is necessary to determine whether the chin alone or chin and projowl areas need to be augmented.
Q. How will I know if I am a good candidate for a chin implant?
Ideal facial aesthetic proportions have been studied and described and it is imperative that each patient undergoes a careful facial analysis by their surgeon in order to assess the particular facial areas that appear out of proportion. During a preoperative evaluation, the surgeon will assess chin symmetry and anterior projection and vertical height of the chin with respect to the entire face, especially the nose. In addition, the bite or occlusion status of the patient will be assessed to determine if there is an overbite or underbite. The development of the entire mandible, or jawbone, is also assessed.
After a thorough evaluation, the surgeon is able to explain the options best suited for the patient. Most patients are excellent candidates for a chin implant irrespective of their bite or occlusion status although some patients may benefit more from orthognathic surgery which involves fracturing the mandible and positioning a particular bony segment more anteriorly.
Q. What kind of implants are used?
Chin and other facial implants (nose, cheek) come in different sizes and shapes. The most commonly used implants are made from a silicone based polymer. These implants are solid but flexible. At Réviance, we will describe the types of available implants during the preoperative consultation and will assess the particular size best suited for each individual patient.
Some implants can be used to augment the chin alone or can augment both the chin and prejowl areas. Additionally, there are specific types of chin implants that can increase vertical height or make the jaw appear more square. We will help determine what type of implant is best suited for the patient based upon each patient’s specific goals and facial anatomy. At Réviance, we use computer imaging during the preoperative consultation in order to best demonstrate post-operative results.
Q. Are facial implants permanent?
Yes, but facial implants can also be removed if so desired.
Q. Can facial fillers be used for cheek augmentation?
Fillers such as Resylane, Radiesse, and Juvéderm are commonly used to augment the cheek, chin, and prejowl areas. Fillers are soft, moldable substances such as hyaluronic acid or calcium hydroxylapatite – substances normally found within the body. Fillers represent an excellent and safe nonsurgical option for augmentation purposes as they can be injected in the office with topical anesthesia and/or nerve blocks (local anesthesia) usually within 30-60 minutes depending upon the areas being treated and the amount of filler being used. Downtime is minimal; patients may have minor bruising and swelling. Other facial areas that are treated by fillers include but are not limited to the lips, lower eyelid region (tear troughs), temples, nose (injection rhinoplasty), acne scars, and forehead creases.
With respect to the cheek area, a careful evaluation by the physician is necessary to assess the different areas that require augmentation. The aging process is characterized by loss of volume in the malar eminence (cheek) areas as well as the ‘tear trough’ areas which are adjacent to the nose and just below the lower eyelid region. By augmenting these areas with fillers, one can achieve a more youthful look from the resulting robust fullness along the cheekbones.
During a consultation at Réviance, we will typically discuss the types of fillers that are available and will determine which type of filler is best suited for each particular area requiring augmentation. In addition to fillers we can also discuss the benefits of fat grafting – a procedure in which fat cells are removed from the thigh or abdomen and injected into particular facial regions in which volume is lost.
Q. Do chin implants feel unnatural?
With proper preoperative evaluation and assessment, an appropriately sized and shaped chin implant can be determined. Proper implant selection and surgical positioning create a natural, harmonious post-operative appearance and feel. It is very rare for a chin implant to feel unnatural after the immediate post-operative phase (i.e., 4-6 weeks) has passed. It is not uncommon for patients to forget that they even have an implant after the initial post-operative period is completed.
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