1.How does a chin implant correct early stages of ageing in the neck?
Dr. D.: We have over 13 models of chin implants, each coming in about 5 sizes, so a lot of choices for our male and female patients.
Some are oval, sound round, some are square, some are very square, some are higher, some are shorter, some are made to augment mostly the pre-jowl depressions, some are meant to augment the vertical height of the chin area, some are “stackable”, etc. I use them in males who want a more masculine lower face (often along with jaw angle augmentation), I use them in ladies who need more “ovality” to the lower face for the “triangle of youth cheek-chin-cheek, I use them when someone wants an angular face (model-like, chin implant, jaw angle implants, buccal fat pad removal), I use them to correct the volume loss seen in aging, I use them also in my transgender patients to convert a feminine chin into a masculine chin and vice versa.
“Most people understand that a chin implant will help in correcting a ‘small’ ‘retruded’ chins, yet few understand their role in youthfulness and restoration when addressing aging”, says Dr. Marc
- Aging is associated with loss of bony, muscle and fatty mass in the face, over time. A chin implant will help to restore this loss in volume. Aging is also accompanied with the appearance of the jowls, the marionette lines and the marionettes “triangles” or zones, the triangular areas seen in front of the jowls (the pre-jowl depressions) and extending up to the mouth commissures – this zone is a common area for filler to replace volume… yet chin implants, with the outer extensions (I call them “wings” when explaining to patients) will more permanently restore the lower parts of the marionette triangles, blending the chin into the jowls and restoring a beautiful jawline and jaw contour.
- With aging, the skin and muscles UNDER the jawline also get looser and adding a chin implant, often with some liposuction to the under-chin area with or without muscle repair (i.e. platysmaplasty neck lift), will help to “taut” the skin and restore a more youthful neck/chin angle
- By adding some forward projection, the chin implants also help to correct the “peau d’orange” (orange’s skin) or pitting over the chin area, commonly seen with aging and its associate volume loss. Otherwise, this “peau d’orange” look is corrected with Botox and fillers.
- A chin implant will always improve a facelift and neck lift result AND will make the patient’s result last longer
2. How does a CHIN implant also help with marionette lines?
Dr. D.: As mentioned above, a chin implant will address very well the lower marionette areas by filling up the pre-jowl depression, blending the chin into the jowls for a smooth jawline and by lifting the marionette shadows forward.
3. Who is a good candidate for a chin implant?
- Patients with a small and/or retruded chin
- Female with a short vertical chin to ovalize her face
- Females with a square chin – females want oval or round – chin shaving might also be recommended to round the chin up
- Males who want a squarer masculine chin – the “alpha”, “leader-of-the-pack” look
- Male-to-female (transgender patient, facial feminization surgery) patients wants more oval chin
- Female-to-male transgender patients want squarer chin
- Males AND females who are aging, have prominent jowls, pre-jowl depressions, marionette zones/lines, loose skin under chin, loss of chin/neck angles
- Patients interested in a more angular face (chin implants, jaw angle implants – think Angelina Jolie – and buccal fat pad removal)
- Patients with a strong nose who like his/her nose; adding a chin implant will enhance their facial harmony and profile; we, plastic surgeons, ALWAYS consider Profiloplasty, or the science of one’s profile:
4. Who is NOT a candidate for chin augmentation with a chin implants
- Someone who already has a large chin
- Someone with unrealistic expectations
- Someone with an active infection at the surgical site
- Someone who is not interested in a foreign material (those could consider fat grafting or fillers)
5. What is the cost of chin augmentation with chin implant?
IMPORTANT to know: The procedure can be done under local anesthesia alone, local anesthesia and deep intravenous sedation or under general anesthesia. Chin augmentation with implant is done in our a state-of-the-art accredited surgical facility Level THREE (highest level). Unlike in the USA and some other practices, prices at VISAGE include the surgery, the anesthesia and anesthesiologist, the post-op visits, the implant(s) and the nurses.
6. How long is the chin implant augmentation surgery? and what is the downtime?
Dr. D.: As a sole procedure, it is approximately a one-hour procedure. It involves a 1,5-2cm incision, under the chin or inside the mouth, creating an exact pocket over the chin bone and under the chin muscle called mentalis. It is important to mention that I use a sizer first to develop the exact pocket so the final implant is inserted perfectly and only once, and the wound is closed immediately without going in and out with the real implants, minimizing contamination of the implants – we do the same with breast implants, pectoral and calf implants, etc.). The implant is secured with 3 stitches to prevent rotation and very rarely screws are needed for chin implants.
Downtime is often minimal when done as a sole procedure as the swelling is not easily seen. Bruising is rare but possible, especially with larger implants; should bruising occur, there might be a 7-10 day “social recovery”. Pain is truly minimal, perhaps 2-3/10 and this is lower with pain medication. The mentalis muscle will require a few weeks to recover. External stitches are in place for 6-7 days. If done intra-orally, dissolving sutures will melt over 7 days or so.
Stay tuned for part 2!
Dr Marc DuPéré, aesthetic plastic surgeon, face and body