CHIN AND JAW AUGMENTATION
Mentoplasty and genioplasty are terms used to describe chin surgery that involves the augmentation or reshaping of the chin. Adding a chin implant is particularly effective when combined with other techniques such as facelifts and neck lifts, rhinoplasty and liposuction of the neck and jowls. Chin augmentation is performed by inserting a silicone implant under the skin. Most often, the incision is made beneath the chin in a natural crease and closed with sutures that are removed in five days. The access incision can also be made inside the mouth, where the lower lip meets the teeth, and then closed with resorbable sutures. The intraoral approach does not leave an external scar but there may be a higher incidence of infection as the implant is placed through a contaminated field. At the end of the surgery, your chin is often taped to minimize swelling, and a compression strap is worn. Insertion of a jaw implant involves incisions made inside the mouth on either side of the lower lip. The incisions are closed with dissolving sutures.
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Craniofacial surgery refers to the field of plastic surgery that corrects misshapen facial bones caused by birth defect or misalignment of the teeth and jaws (malocclusion), or mild inadequate tissue development (hypoplasia) which can appear as a recessed upper jaw. Chin reduction surgery involves bone reduction with power bone instruments. If you have a chin deficiency, bone surgery or an osteotomy may be necessary. This involves moving the bone of the chin forward following various oblique bone incisions to reshape the chin. This operation can also be performed in conjunction with nose surgery as well as liposuction of the face and neck.
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Possible complications of facial implants include: implant extrusion, capsular contracture, asymmetry, infection, bone erosion and sensory changes. An implant that is too large or has inadequate soft tissue coverage may gradually resurface through the original access incision or through a new site. Capsular contracture is abnormal tightening of the scar tissue that normally forms around the implant and can cause distortion of the implant. A facial implant can sometimes shift slightly out of alignment or be placed improperly, and a second operation may be necessary to replace it in the proper position. If an infection occurs, the implant may have to be temporarily removed and replaced at a later date. Underlying bone may gradually erode and become thinner under cheek or chin implants. The treated area may develop numbness that usually resolves after several months, although long term numbness is a potential complication. In rare cases, nerve damage may occur if the implant is resting on one of the facial nerves.
After facial implant surgery, swelling can be significant and usually peaks 24 to 48 hours afterward. You will be instructed to keep your head elevated as much as possible in the first few days after surgery. Swelling and bruising can be minimized by an application of tape or elastic band for about a week after surgery. Applying cold compresses will reduce swelling and discomfort. The treated area may feel tight and stiff and movement of the mouth may be difficult initially following the surgery. Some difficulty talking, eating and smiling for several days following the surgery is normal. Patients with sutures inside the mouth are sometimes placed on a liquid diet for several days. Removable sutures are used for incisions under the chin and are taken out after five to seven days. You can return to work in one to two weeks, and resume exercise in three weeks. Avoid contact sports or any activity that may result in the face being jarred or bumped for several weeks. Although most of the significant swelling will subside over the first several weeks, mild swelling may remain for months before the final facial contours are evident.
Another way to approach the chin and jaw is with orthodontics, which can treat a malocclusion and misaligned teeth, and can significantly change the overall shape of the face. Fat transfer and other filling substances can also be used to augment the cheeks and chin. Sculptra is a dermal filler that has had more widespread use in filling large soft tissue deficits, and enhances the contour of the cheek area.
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