Chin augmentation surgery, also referred to as mentoplasty, is a cosmetic procedure which permanently improves chin projection, jaw definition, and contour between chin and neck. Chin augmentation surgery may be performed on its own, though it is often combined with rhinoplasty in order to achieve the best facial balance.
Some of the most common cosmetic concerns leading to chin augmentation surgery include:
A person’s profile is held in balance with the chin and jawline. Typically, the most esthetically pleasing male jaw will come up to or just past an imaginary line dropped down vertically from a person’s lower lip. An ideal female jaw line typically comes just short of the line down from the lip.
The chin augmentation procedure most typically includes the placement of a permanent chin implant and it may also include liposuction. A small incision is placed in the crease beneath the chin, which, when mature, results in a well-camouflaged, imperceptible scar. Dr. Moynihan prefers this incision location for chin augmentation surgery over an intraoral incision as it involves decreased infection rates, prevents migration of the implant superiorly, and avoids damage to the muscles responsible for lower lip movement. Once the incision is made, a silastic implant is inserted into the chin area.
The majority of discomfort is experienced within the first three days, with seven days of cosmetic down time. Swelling and bruising may occur and a soft diet is advised. The patient must limit their smiling and speaking within reason during the first week to ensure proper integration of the implant. Most social, professional, and physical activities may resume within 7-10 days and more specific guidance is provided on a case-by-case basis.
The cost of a chin augmentation is determined by several factors and it is important to understand what is included in a quote. Typically, expenses include an anesthesia fee, an operating room fee, or both. Some chin augmentation surgeons charge separately for the implant product whereas others will incorporate it into their surgeon’s fee. Prescriptions may be included in the quoted fees or they may be submitted to your local pharmacy for you to pick up at your own expense.
Dr. George Moynihan’s patients typically spend a true total of $6,500-$8,000 for all expenses involved with their chin augmentation. A more specific quote may be provided prior to the consultation when photos are submitted and a final, all-inclusive quote is provided during the consultation.
The chin augmentation procedure is performed under sedation (aka ‘twilight’ anesthesia). The medicine is delivered through an IV which allows the patient to continue breathing on their own while comfortably unaware of what is happening.
It is always placed through the outside rather than through the inside of the mouth for three reasons:
1. There is less bacteria present on the skin surface than the mouth. This reduces the chances of the implant becoming infected.
2. In order to place an implant, a pocket to receive the implant needs to be made larger than the implant. So if the implant is placed from within the mouth and from above, the larger pocket allows the implant to be migrate upward. An implant that migrates upward will create an unnatural look. If the pocket is made from below via an external incision, the only place an implant can migrate is downward which is not noticeable cosmetically.
3. It is possible to damage facial musculature that is responsible for your characteristic smile when placing an implant from within the mouth. This is not a risk from the external approach.
The implant is placed under the lining of the bone-periosteum. The periosteum is a dense layer of tissue that is tightly adhered to the bone. Once the implant is placed, the implant is secured with a 6-month dissolving stitch that allows the periosteum to ‘shrink-wrap’ around the implant. After several weeks, the implant becomes completely secured and extremely difficult to dislodge.
The most common silastic implant used by Dr. Moynihan is a Mittleman pre-jowl extended implant. Using a silastic implant has two advantages:
1. It allows sculpting of the implant to suit each person’s anatomy.
2. If a person is unhappy with an implant no matter how much time has passed since the placement of the implant, the implant can be removed in the office with very little difficulty.
For males seeking a ‘squarer’ jaw, a Terrino implant is the better choice for a more dramatic masculinization.
Complications are extremely rare with chin implant surgery. Infection is a possibility and if it occurs it requires removal of the implant. Chances of infection are significantly reduced by the use of an operating room and various OR techniques that can be explained in the office. Permanent or temporary numbness of the lower lip and chin region. This is reduced by marking the most likely area of the mental nerve on the patient’s skin prior to sedating the patient while in the upright position.
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