Dr William Portuese is board certified by the American Board of Facial Plastic and Reconstructive Surgery and by the American Board of Otolaryngology, Head & Neck Surgery. He focuses on facial plastic surgery procedures including:
facial rejuvenation services both surgical and nonsurgical
The chin and nose are the facial features that most clearly define your profile. An aesthetically pleasing profile is generally considered to be one in which the chin is located 2-3 millimeters behind an imaginary vertical line that extends downward from the foremost point of the upper lip. A chin that projects past this point may be regarded as a "strong" chin, while one that falls far short of this line may be referred to as a "weak" or receding chin. Since a strong chin and jawline are often identified as signs of masculinity, men may be especially concerned about a receding chin. While in women a chin positioned slightly behind the imaginary vertical line may be acceptable and even sometimes preferred aesthetically, one that recedes too far creates a less flattering profile. A receding chin can also make an otherwise average size nose appear too large. In some instances, increasing the chin's projection can bring the entire profile into harmony, even eliminating the need for rhinoplasty. In other cases, your facial plastic surgeon may suggest chin augmentation
What is a chin implant?
Chin implants are composed of solid silicone, and are placed through a small incision underneath the chin to augment the chin forward. They are placed for patients who have a weak and recessive chin profile. Chin implants can be custom carved when necessary to match patient's unique anatomy.
How many different sizes do chin implants come in?
Chin implants are manufactured in a very large array of thicknesses, sizes, and shapes which is best determined at the time of the examination and consultation. It is important to know how much augmentation the patient is trying to accomplish in addition to their anatomy of the recessive chin profile. In our practice for over 25 years, we have used Implantech brand of solid silicone chin implants with an excellent success rate. Digital computer imaging is also helpful in the communication process to understand what can be accomplished with a chin implant procedure upon your facial features.
What type of anesthesia is used for a chin augmentation?
Most patients who undergo a standalone chin implant are performed under local anesthesia and can walk in and out of the office on their own accord. Some patients do not wish to undergo the procedure under local anesthesia, therefore general anesthesia is used, however there is an additional charge for the anesthesiologist.
Is a chin implant procedure painful?
A chin implant procedure is not painful. Most patients take either Tylenol, or a few medium strength Vicodin pain pills for the entire postoperative course. While the chin itself is not painful after the surgery, it is certainly tender if it is accidentally bumped for the first few months after the procedure.
Chin augmentation is generally performed only after the facial bones are fully developed, usually not before the age of 15 in girls and 17 in boys. Chin augmentation with implants, genioplasty (where the patient's own chin bone is shifted forward and secured into a new position), or chin reduction surgery can recontour the lower face to create a more pleasing profile. Chin augmentation can also be achieved through injections of fat or other soft-tissue fillers.
The consultation is a time for you and your surgeon to get to know and feel comfortable with each other. You should feel completely confident that the surgeon is fully qualified If you haven't read sections in the beginning of this book about choosing a surgeon who is certified by the American Board of Plastic Surgery, you may wish to do so now. A board-certified plastic surgeon will determine if you are a suitable candidate for surgery and will want to review your entire medical history, as well as any medications you may currently be taking. Your surgeon will evaluate several factors, including the size and shape of your chin, the angle between your chin and neck, your bite and the condition of your teeth and gums, your skin texture, bone structure, facial sensation and muscle function. It is also important that any pre-existing asymmetries of your chin or jawline are identified and addressed.
Your facial plastic surgeon will discuss the overall structure of your face and how modifications to your chin would affect your facial balance. He or she will explain the details of the procedure, such as incision placement and whether or not an implant will be used. Your goals and the aesthetic judgment of your surgeon are both important factors in determining how your chin contour will be modified. In some cases, the jawline may need to be reshaped, and there are special implants that may be used for this purpose.
" A young female patient I saw in my office, who had a very narrow face, had undergone previous chin augmentation that really had not achieved an aesthetic result. In fact, I felt that her prior surgery had actually made her lower face look more out of balance with her other features. I ultimately removed the chin implant and, instead, recontoured her jawline to give it more prominence, which significantly improved her facial balance."
You and your surgeon will work together to determine the best surgical plan to fulfill your desires and meet your individual needs. If appropriate, your plastic surgeon may discuss with you other procedures that are often done in conjunction with chin augmentation, such as rhinoplasty and liposuction and eyelid surgery to reduce fatty deposits that can create the appearance of a " double chin."