Mentoplasty (Chin Augmentation)
Patient Information
Our facial appearance is created by the underlying facial bones, dimensions and musculature. Therefore, anatomy determines whether a person has strong projecting cheekbones, an angular or soft jawline, the nasal shape and the size of the eyes. Harmony and balance of features is generally considered attractive.
In the female patient, attractiveness is strongly related to proportion with an emphasis on cheekbone projection and a soft, tapered jawline. Attractiveness in men is often attributed to chiseled, angulated looks. Strong facial bones can create a very masculine and distinguished look. For both men and women, the profile view of the facial features, particularly the forehead, nose and chin, is critical to facial harmony and balance. The proportion, shape and projection of these anatomical features – and the relationship to surrounding features --directly influences the appearance of the other structures.
For example, it is common to see individuals with small, under-projected or receding chins. This recessed chin strongly influences the profile by creating the appearance of the nose being more prominent that it actually is, with the chin becoming the focus of attention. When the chin is in harmony with the other facial features, attention is drawn away from the nose and chin giving the entire profile balance.
Under-projection of the chin may occur secondarily to a congenital (birth) malformation, as a developmental malformation, or, as an acquired deformity. Congenital malformations occur during fetal development and are usually a component of a syndrome. Developmental malformations occur as a result of trauma to the jaw during infant development, or from genetic, infectious, hormonal, or nutritional abnormalities. Acquired deformities result from accidents, injury, or surgery to the jaw.
Over-projected chins, on the other hand, masculinize a profile or give it an “old person” appearance. An excessive chin often softens the nose and creates strength or obtrusiveness to the physical feature. In the male patient a strong chin is a favorable aesthetic feature, whereas in the female a well proportioned, slightly under-projected chin is favorable. In some cases, what the patient considers a profile problem is not the chin itself, but rather excessive skin and fat that has accumulated under the chin with gravitational influences and aging. These require additional restorative techniques. Some patients have malocclusion (teeth that do not fit together well), thus an oral/maxillofacial problem may be present. The chin projection also affects its relationship to the neck, creating the cervical mental angle. This angle is often the focus of beauty which is commonly characterized in youth and accentuated in fashion and the media.
Mentoplasty is the technique of chin augmentation by which a person’s soft or under-projected chin is accentuated. Mentoplasty improves the projection of the chin, bringing it into harmonious proportion. This technique may be performed individually, or during another procedure such as a rhinoplasty (nose surgery) or facelift. Additionally, liposuction under the chin or facelift surgery may improve the aesthetics of the chin. In certain patients, chin advancement procedures by which the jawbone is cut and slid forward is necessary with certain orthognathic problems.
Chin reduction surgery, on the other hand, involves removing or reducing the excessive chin projection. This typically requires shaving of the excessive chin bone in order to soften and reduce the projection. This technique must be strictly individualized as it can lead to more sagging of the chin.
During your experience at the Institute of Aesthetic Plastic & Reconstructive Surgery, you will have personal interaction with Dr.Schmid, his staff, and an educational experience. In your private consultation with Dr.Schmid, your aesthetic concerns and personal characteristics will be thoroughly evaluated to determine whether corrective surgery of the chin and face are promising options for you. It is important that you openly express your expectations and goals from the cosmetic procedure.
As part of the consultation, computerized facial imaging will be available to help you visualize pre and postoperative changes possible through cosmetic surgery. Computer facial imaging is important as it opens up communication and understanding of the options and limitations inherent in any surgical procedure. This technique is provided at your request and it should be understood that it is for illustration purposes only. It is very beneficial in observing the changes/improvement in facial balance with computerized chin augmentation and should be considered a demonstration purpose only. Also available during the consultation is review of an appropriate implant to suit your cosmetic needs. Small sizers will be applied along with review of the implant material (Silastic, Goretex). Photographs will be taken to allow for documentation and preoperative planning if surgery is decided upon.
If surgery is agreed upon, preoperative planning will commence which will require a history & physical, and at times lab work to ensure your medical stability. My office staff will offer counseling and assistance in your preparation for the surgical procedure. The surgical procedure of mentoplasty is typically performed in our office surgical suite, however, may be performed a hospital setting if you prefer. Mentoplasty is performed on an outpatient basis and may be performed as an individual procedure, or in conjunction with other cosmetic procedures (i.e., rhinoplasty or facelift surgery). The procedure can be combined easily with removal of fat and a small amount of skin from underneath the chin, called a submental lipectomy, which treats a double chin and can improve the overall aesthetic result.
Chin reduction, on the other hand, is accomplished by surgically planing down the prominent chin bone with a drill. Both procedures are performed through a small incision in a fold beneath the chin. The incisions for the procedure are made either inside the mouth or just underneath the chin. The technique is performed in a sterile setting and may be performed under local or IV sedation. Once the implant is inserted, it is secured at the anterior edge of the jawbone to establish projection of the chin. The skin overlying the implant retains its smooth contour and the implant becomes virtually undetectable after the recovery period. Chin augmentation is designed to make the new chin look as natural as possible. The implants are typically made of Silastic or Goretex which are very compatible inside the body. They have a firm consistency which simulates bone.
After the surgical procedure, you should expect swelling, bruising and numbness at the surgical site. Additionally there will be dressings over the chin which must remain in place for up to one week after surgery. The majority of the swelling usually subsides within the first week, the bruising within a couple weeks. There may be some mild discomfort after surgery, but this is usually controlled easily with analgesics. Significant pain is uncommon. Overlying dressing will be applied after the surgery to maintain the position of the implant. These dressings will be removed on your follow-up visit when your sutures are removed.
Significant improvement should be noticed immediately following surgery. The chin will even look more natural and attractive as the swelling subsides in the weeks after surgery. Just how much improvement is achieved depends upon the individual’s physical characteristics and the extent of surgery. Final results are also dependent upon the patient’s dedication to postoperative care and avoidance of chin trauma. The outcome of any surgical procedure is highly dependent upon individual healing/response to surgery. No guarantees can be made as to the specific outcome of any surgical procedure.
There are potential risks involved with any surgical procedure, even when the utmost care, skill, and judgment are exercised by the surgeon. Fortunately, complications associated with chin implant surgery are rare. The risks involved with this surgical procedure include infection, bleeding, scar formation, prolonged swelling, tenderness and implant rejection. Other risks involved include lower lip and chin numbness (usually temporary, rarely permanent), bone resorption under the implant, asymmetry, and displacement of the implant with trauma. These risks have been mentioned for completeness and to give you disclosure, but are very rare.
Since this is an elective cosmetic procedure, the fees for mentoplasty are to be paid in advance of the surgical procedure during the preoperative planning period since this type of surgery is not covered by medical insurance. Additionally, there will be an anesthesia cost (if elected) and additional costs to include surgical facility fee and an implant fee. Fees for elective facial plastic surgery vary widely and depend upon the extent and complexity of the cosmetic procedure.
I personally look forward to working with you as a patient to address your aesthetic needs. I feel it is important to educate and communicate with you as my patient and discuss all options and events surrounding any procedure to full disclosure. My staff and I will be available to answer any questions you have and offer any support you should need throughout your course of treatment to make your recovery period as comfortable as possible.
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PMS/kdw-03/21/03
(Mentoplasty - Chin Augmentation Patient Info)
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Mentoplasty (Chin Augmentation) Patient Info