Chin Augmentation / Genioplasty / Chin Implants
The chin is very important to the overall balance of the face. A large or small chin may create a proportional imbalance with other facial features such as the neck, lips, nose and forehead. A chin that is too large in dimension can be reduced, and the chin that is too small can be augmented.
It is very common for patients to seek chin augmentation. This is accomplished by advancing the chin to achieve the most ideal and natural result. The chin is also improved vertically and in its width so that the jawline has a more contoured continous balance. Implants can be used, but there are limits to their use, since they do not achieve 3 dimensional changes such as changing the width, height and projection of the chin. The type of procedure one chooses depends on the degree of chin recession and the patient’s individual goals. These chin surgical procedures are often done in concert with other cosmetic procedures. Since the chin is an important part of the jawline and the neckline view; it is also important to ensure the ‘front’ look of the chin is well balanced as well. Dr Wittenberg always contours the chin to ‘blend’ into the jawline for the most impressive results.
Its all about Balance
It is important to understand the Balance of the entire jawline when you consider a chin augmentation. The chin has to ‘blend’ into the jawline, which can require the coincident augmentation of the ‘back of the jawline (ramus of the jaw). It is necessary to understand that the jaw is composed of 3 zones or anatomic areas – the angle of the jaw, the midbody of the jaw and the chin. Dr Wittenberg is one of the only surgeons who achieves the natural contours of all 3 areas so that the entire jawline looks well defined.
Chin implant or Sliding Genioplasty?
As well, the chin has to be balanced 3-dimensionally so that the width, the height and the prominence are contoured and adjusted properly. For example, implants in the Chin cannot properly alter the height of the chin, nor can they achieve a natural flattening of the area under the chin – only bony surgery, which extends the muscles under the chin, can accomplish that feature. The ‘double chin’ is best improved with a natural bony surgery to ‘stretch’ the muscles in this area – sliding genioplasty. (Chin implants can cause a loss of bone under the implant over time, and injure the teeth roots; and often ‘migrate’ upwards somewhat above the actual ‘chin point’ where the augmentation was aimed).
What about my neck?
The area ‘under the chin’ can be adjusted with liposculpture techniques to achieve a trim look to the neckline; at the same time as the chin is augmented.This is common at many ages and is evaluated during the consultation. If the tissue is quite lax in the mature patient, the soft tissue can be adjusted to achieve the most idealized cosmetic result. In the mature patient, a procedure under the chin called a platysmaplasty, can be used to tighten the muscles and flatten this area so one gets rid of the double chin and sagging skin look. This is often combined with a necklift which allows the neck to be significantly rejuvenated and recontoured.
The look in the mirror – from the front
The chin is the ‘front’ of the lower jaw and one has to consider the ‘side’ and the ‘angle’ of the jaw in order to achieve an idealized ‘jawline’. This is critical since the primary way we see ourselves, is from the ‘front’ and not the actual ‘profile/side’ view. The shape of the face depends largely upon the contour of the jawline and therefore, it is common to perform augmentation of the entire jawline when one considers a chin surgery/genioplasty. Dr. Wittenberg can explain your features to you and can guide you in your selections.
The chin surgery is accomplished from inside the mouth without skin incisions. The physical recovery approximates 4-7 days dependent upon the specifics of the surgery. Swelling is not significant but would usually improve within the week, in any event. The procedure is described as ‘heavy fullness with some achiness, but not painful at all”. The results are immediate and the improvement in the facial balance is impressive.
V-Line Surgery – A tapered jawline
There are patients who prefer a thinner, more tapered look to the face; and who already have a relatively wide and strong jawline. In many cases, one can ‘taper’ or feminize the jawline with alterations of the bony shape extending from the angle of the jaw to the chin. The entire jawline is refined. Common in Asia, this approach is well practiced by Dr. Wittenberg. The change in the chin contours can involve width and height of the chin. The final appearance should look perfectly natural.
Double chins – what is it really about
The area ‘under the chin’ is an area we notice both from the front and the side view/profile. It can look ‘full’ even when we are young and our overall weight is fine. It can also look ‘saggy’ and turkey-like, as we age and lose the elasticity in the skin and muscle tissues.
When we review the contours in this area, one has to consider several factors. One is the actual ‘length’ between the throat and the chin point, since having a small chin or small lower jaw, will emphasize the fullness in the area. In that case, a sliding genioplasty or lower jaw surgery can extend the length of the muscles and flatten this area naturally.
A second concern is that some persons have a genetic tendency to accumulate a ‘fat pad’ under the chin and you may need liposculpture to reduce the fullness and expose the flatness of the underlying muscles. The other concerns relate to the skin and muscle laxity with aging. In this case, the muscle needs to be ‘tightened’ and the skin tensed, so that the overall contours improve quite impressivley.
Of course, all of these concerns have to be reviewed at the consultation and a plan developed that suits your facial balance. Dr. Wittenberg is particularly adept at recontouring and improving this area and can assist you obtain the best result. He is the very rare surgeon who understands and treats both the underlying facial bone structure as well as the overlying soft tissues.
Dr. Wittenberg is truly an expert in Facial Surgery of the lower jaw and can advise you as to how to achieve the most natural and balanced appearance.
Please view our Before & After Gallery for Chin Augmentation.