Augmentation mentoplasty; Genioplasty
A chin augmentation is a surgical procedure to reshape or enhance the size of the chin to restore facial harmony and chin projection.
The facial profile can be balanced by extending the chin in relationship to the nose. Reconstructive mandibular sliding surgery to correct bite dysfunction can be performed in conjunction with chin surgery. Thousands of genioplasties are performed successfully each year. Surgery may be performed in the surgeon’s office-based facility, a hospital, or an outpatient facility.
In children general anesthesia is used to eliminate apprehensiveness and produce sleep throughout the operation. In adults, clinical assessments including X-rays of the face and chin are used for preoperative planning.
One surgical approach is to make an incision inside the mouth along the inferior sulcus (a “landmark” inside the lower gum) to gain access to the chin bone. A horizontal cut (called an osteotomy) is made through the jaw bone (mandible) with a bone saw or chisel. The lower portion of the separated bone is moved forward to the desired position and wired or screwed in with titanium plates. The mental nerves are carefully protected. The incision is closed with sutures and an external pressure dressing is applied. There is no visible scarring since the surgery is performed through an incision inside the mouth.
When only a modest degree of chin augmentation is required to provide contour, the surgeon may use a prosthetic chin implant (artificial - made of silicone, teflon, or dacron), or may use bone only. The incision is made either inside the mouth or externally under the chin. A pocket is created in front of the chin bone and under the muscles, and an appropriately sized prosthesis or chin implant is inserted. The incision is closed and a pressure dressing is applied. The resulting external scar is barely visible.
The best candidates for genioplasty are patients with weak or receding chins (microgenia), but with a normal dental bite. Expectations of looking and feeling better after surgery should be discussed with the plastic surgeon before any surgery, keeping in mind that the desired result is improvement, not perfection.
Movement or displacement of the implant, bruising (ecchymosis), and swelling of the chin are the most common complications. Infection and blood clots are rare postoperative problems. Nicotine from smoking can delay healing.
Expectations after surgery
There is some discomfort and soreness, which is easily controlled by medication. A liquid diet may be advised for a day or two. Light activity can resume the same day as surgery.
Return to work and usual activity is allowed within 7 to 10 days. Within a week of surgery, the external dressing is usually removed.
by David A. Scott, M.D.
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