| Pre: A 48-year-old patient prior to a chin augmentation
|| Post: 2 week post op after a chin augmentation medial and lateral platysmaplasty.|
Analysis of the chin must examine the proportions of the face, the type of bite or occlusion, and the soft tissue overlying the chin.
There is a general ratio of thirds involving the forehead, mid face, and lower face. The chin should be balanced in height and width. Laterally the chin should have a harmonious projection in relationship to the lips and the nose. The skin and muscle should not hang from the chin (a witch’s chin). The mental-labial groove above the chin should not be too deep. The bite should be a class 1 with the maxillary teeth slightly over the mandibular teeth. The teeth should be centered. The chin asymmetry should be minimal.
The analysis will note the bone and soft abnormalities and then generally classify the corrective techniques based upon bone and soft tissue abnormalities.
Most plastic surgery of the chin assumes that the bite is normal. The most common deficiency is a weak, or retrograde chin. This is corrected with chin augmentation which uses either fat grafts or more commonly a smooth nonreactive silicone implant (I have seen other types over the years but they are more reactive).
Every implant is customized to that person so as to give a natural result. The approach is usually through the mouth unless there is a contributing issue. The most common size is small to medium. Fat grafts work well for smaller augmentation and especially for asymmetry. The time for the procedure is 1 hour.
Many people find that the surgery can be done under regional anesthesia and oral medication. This allows for a rapid recovery and is less expensive. Pills are taken pre-operatively and Novocain is then injected.
The recovery time is 1-3 days. I place patients on a mild steroid to reduce swelling. Sutures are dissolvable.