Chin Augmentation FAQ

A chin augmentation is a procedure that increases the projection of the chin as well as the height of the chin. It is usually done with an implant, but a chin augmentation can also be done by moving the bones of the chin.

When viewed in profile, the projection of the chin plays a very important role in balancing the forehead and nose. A small chin can make a nose look large; a large chin can make a nose look smaller. In the front view, a short chin results in the face looking "top-heavy".

A chin augmentation is a very common procedure. When was the last time you saw someone and thought they had a chin implant? Those of us with "Jay Leno chins" were born that way. While plastic surgeons may overdo breast implants, the same probably cannot be said about chin implants. The results of a chin implant are subtle but profound.

A chin implant is commonly done on its own. But it is also quite commonly done with other procedures. Many patients who end up getting a chin implant do not come to the plastic surgeons specifically requesting it. They may say that their jawline or neck looks weak in profile or that their nose looks too big for their face. Figuring out that the problem is with their chin is something that only happens at their consultation with a plastic surgeon. Many of these patients may want to have a facelift or a necklift. Some with a double chin will also get liposuction of their neck. And some who initially saw the plastic surgeon for treatment of a bump on their nose may end up still doing their nose along with their chin.

By increasing the projection of the chin, the neck looks more angular, lean, and youthful. Some patients who think they need some sort of a neck lift really are best served with a chin implant, either alone or with some type of a neck lifting procedure. And as the neck skin is distracted forward even a little bit by a chin implant, there is a greater amount of tightness noted in the skin underneath the jaw.

The chin plays a critical role in setting up balances in the face and in the neck. While men are typically considered more attractive when their chins are stronger and squarer than the chins in women, an attractive and balanced chin is important for both genders. People with weak chins simply do not look as healthy, fit, and energetic. A strong chin creates a greater appearance of strength and self-confidence. Its role in balancing the nose and forehead are very important in creating ideal facial proportions.

The nose and the chin are like a "teeter-totter" across the lips. A big nose can make a normal chin look small, and a small chin can make a normal nose look big. Dr. Teitelbaum does not bring up procedures in consultation that the patient did not ask about. The only exception is the chin; so often patients who come in for a rhinoplasty also have an issue with their chin, and ignoring the chin means not properly diagnosing the issues with the nose.

Nearly all chin augmentations are done with a chin implant. But there are also procedures done in which the jawbone is cut and moved to create an increase in vertical height or length of the lower jaw.

Once everything has healed, a chin implant will stay position. But sometimes in the early weeks after surgery and before everything has completely healed, the chin implant can move out of position. This is very uncommon, but correcting it does require returning to the operating room to put it back into position.

Most patients love their chin implant and never want it removed. But there are some patients who may have never needed it and want it gone. Removing a chin implant is a relatively straightforward procedure and usually proceed without a problem. But there are some cases in which the implant created a little depression in the bone beneath it, so that after the chin implant is removed the patient has less overall chin projection than they originally had.

A chin implant never needs to be replaced. Unlike a breast implant, a chin implant is solid; there is nothing to leak out of it. Most people have one chin implant and it will last them a lifetime.

The chin will look augmented as long as the implant remains in place.

Most chin implants today are made out of solid silicone. Implants have also been made out of GoreTex as well as an artificial bone. But those are rarely used, if at all.

There are many different shapes of chin implants. Some wrap widely around the jaw bone and others are very narrow and only project at the very front. Chin implants can be thin, augmenting only along a narrow area, or they can be tall. And they can wrap around the jawbone to varying degrees. They can have more of a pointy shape or a square shape.

A sliding genioplasty is an operation in which the jaw bone is cut and the lower portion is slid forward and held into place with screws. It is an alternative to a chin implant.

A chin implant mostly increases projection. It can only increase the height of the chin by a small amount. But a sliding genioplasty can increase the height by as much as is necessary in addition to increasing projection. It also does not involve any sort of implant. But it is a bigger operation. Dr. Teitelbaum does not perform this procedure, but refers patients to trusted colleagues who are interested in or who would be better treated with it.

A chin augmentation is a cosmetic procedure and is never covered by insurance.

The nose and chin perform an important balancing act. A small chin can make a nose look larger.

Many patients who end up getting a chin implant seek out plastic surgeons because of concerns about their neck in general, and they may have excess fat in their necks or even double chins in addition to a small chin. When appropriate and done together the results are outstanding.

The prime concern of many facelift patients is their neck, and by elongating the lower jaw a chin augmentation will typically improve the neck. Some patients also lose some chin fat or develop some drooping of the chin with time, and a chin implant can help with these issues. And of course there are many people who have had small chins their entire lives and decide to finally improve their chin at the time of their facelift.

A chin augmentation takes little time and adds little surgical risk, so it can be safely done in combination with nearly any other plastic surgery operation.

Chin augmentations can be done with local anesthesia, local anesthesia with IV sedation, or with general anesthesia. But it can be unnerving to patients to feel the implant placed along their jawbone, even when there is no actual pain. So the vast majority of chin augmentation patients opt to do it with a light general anesthesia. The anesthesia is short-acting, so patients wake right up after the procedure and do not develop nausea or other similar anesthetic issues that day.

A chin implant can be inserted through an incision inside of the mouth or under the chin. While it is attractive to hide a scar inside of the mouth, the under the chin incision is essentially invisible, and more people than not have a small scar there anyhow from a fall as a child and will tell you that the scar is never noticed. The key point is that the underneath incision gives the surgeon clearer visualization and probably less pain. When using longer implants that taper gradually out to the sides, insertion can be problematic from the mouth. The mouth incision also involves working around nerves that supply sensation to the lip, and stretch injury to those is less common with the underneath incision. It is also important to reduce bacterial contamination of any type of implant because of infection concerns, and the underneath incision reduces that risk.

Chin implant malposition is probably the most common problem after chin augmentation. The implant can settle a bit high or low, or even tilt a bit. In some cases the long end of a tapered implant can double back on itself. These problems can be reduced but not eliminated with careful surgery. Postoperative pressure such as sleeping on the chin or other forces against it can also move the implant out of position. If these problems happen, it is usually noticed within the first several weeks after surgery. Correction requires going back to the operating room and tweaking the implant into a proper position.