How is a chin implant inserted?

Written by Dr. Julian De Silva

Dr. De Silva may suggest a chin implant to give more balance to a person’s face and an even better result. Chin deficiency is usually apparent on looking at a person’s side profile, where the chin should align with a vertical line drawn through the philtrum (junction between nose and upper lip). Dr. De Silva uses silicone implants and specially customizes the implant with sculpture to fit a patient’s individual jaw line. A chin implant is a very low risk implant that can greatly improve harmony of a patients face, and is completely removable. The chin implant can be inserted into place under local anaesthesia with or without sedation, by making a small incision under the chin in a natural hidden crease. Patients are given a week of antibiotics as a preventative measure against infection, the stitches are removed after one week and the implant requires no further management. Dr. De Silva inserts chin implants on their own as a single procedure, or commonly used in conjunction with rhinoplasty, facelift or neck lift surgery to enhance the result.

Watch Video: Chin Implant Animation Video - How is a chin implant inserted?
Chin Implant Animation Video - How is a chin implant inserted?

Although Chin surgery, traditionally involved making cuts into the jaw (mentoplasty) and resetting of the position of the jaw. This involved substantial surgery with realignment of the jaw there was a longer recovery time, risk of cross bite and nerve injury. Chin implants provided a very safe way of avoiding mentoplasty, while restoring natural proportions to the face. In a woman, a chin implant restores harmony and natural beauty, in a man the chin is one of the features of sexual dimorphism and makes a male face more masculine and attractive.

A chin implant or chin augmentation is a procedure that Dr. De Silva performs relatively frequently if you have a small chin or if the lower portion of the jaw bone lies behind the lips. The name given to this appearance in medical jargon “microgenia” (micro means small, genia means chin). Chin implants are frequently needed to give a better result with rhinoplasty in about 20%. Dr. De Silva takes multiple High Definition photos of your face in profile and uses the latest in Digital Animation to simulate the size of the chin implant, in some cases he will be able to visually show you an approximate result of a chin implant.

Who needs a chin implant?

This figure on the left shows the normal position of the chin in relation to the lips. In a person with good facial proportions the lower lips is 1-2mm behind the upper lid and the chin is 1-2mm behind the lower lip. There are variations in facial harmony and balance based on genetics, gender and ethnicity.

The figure on the left shows the position of a recessed chin which is positioned (>5mm) behind a vertical green line drawn through the lips. With chin augmentation the chin is moved forward and the relative distance from the lips to the chin is reduced. Dr. De Silva uses reference points on the face to evaluate proportions, however the artistry of chin augmentation also includes taking in to account gender, ethnicity and chin shape into account with chin shaping.

Woman's face, before and after Chin Implant treatment, female patient, left side view

Why have a chin implant?

Common reasons why patients ask Dr. De Silva for help?

  • Self-conscious about side profile
  • Hiding your chin e.g. avoiding photos
  • Filler is okay short-term solution, limited improvement as a soft gel, costly & inconvenient long-term
  • Consciously pushing jaw forwards to hide chin
  • Men often grow beard, older appearance

Dr. De Silva also recommends

  • Natural shaping of implant to jaw line (*key importance for natural look)
  • Avoid movement with fixing implant (Dr De Silva uses two 8mm titanium screws)
  • Chin implant major advantages in recovery over alternative invasive surgery (genioplasty, jaw surgery)
  • Younger patients with fuller neck, shaping and contouring of neck with customised liposuction and Dr. De Silva’s signature tightening stitches (*for specific patients provides greater definition neck)
  • With Dr. De Silva sedation anaesthesia, able to come home in less than 1-hour after procedure

Are other procedures used at the same time as Chin Implants?

Chin implants are often used in conjunction with rhinoplasty to improve balance in facial proportions and give a better result. In addition neck liposuction can be beneficial for some patients with fat under their chin as the procedure will improve the natural jaw line and attractive angle between the jaw and chin.

In patients wither further signs of facial ageing, there maybe laxity of the skin and soft tissues with the appearance of jowls, deep facial lines and neck skin folds. Patients with these signs of facial ageing would benefit from a face and neck lift in addition to the chin implant.

Before & After

Woman's face, before and after chin implant, treatment photos, front,side,oblique face photos - female patient 1

*Results May Vary

What are the surgical techniques for insertion of a Chin Implant?

There are two techniques for the insertion of a Chin Implant: Surgery from the inside the mouth (Intra-Oral) and insertion of the Chin Implant from a small hidden incision under the chin (Sub-Mental Crease). Dr. De Silva performs both techniques, he tailors the surgery to the individual, his procedure of choice is insertion of the implant through the sub-mental crease as this enables good access for optimal position of the implant. Intra-Oral insertion of Chin Implants is associated with an increased chance of infection of the implant and a longer recovery period. Dr. De Silva sculpts every chin implant to a person’s unique jaw line, every jaw line is different and requires a different 3-D enhancement to give the best result. Natural variation in the chin, jaw and neck skin, soft tissues and skeletal structure mean that optimal proportions differ in all faces.

There is a degree of artistry in all individuals’ faces that each surgeon interprets and adds to, much like each chef has their own individuality to every dish they serve. Particular importance is shaping the implant to soften the appearance of the chin and ensure a natural jaw line (shown with hatching in the figure below). Dr. De Silva is known for natural looking work and customization of techniques that are in harmony with a person’s facial characteristics.

Anatomy: Chin Implants

This figure is taken from Dr. Julian De Silva's forthcoming book on facial cosmetic & plastic surgery. The figure on the left shows a recessed chin in which the chin lies behind a vertical line from the lower lip. The image on the right shows the improved position of the chin following augmentation of the chin with a high-grade silicone implant that sits along the lower part of the jaw simulating bone. Hatching shows area of the implant that Dr. De Silva shapes to fit the individual's jaw line. The front aspect of the implant is where the position of the specialised screw sits. The small circle that is positioned above the chin implant is the position of the mental nerve that supplies sensation to the jaw and teeth and is avoided during the chin augmentation procedure.

Are there alternatives to a Chin Implant?

According to London based facial cosmetic expert, Dr. De Silva recommends Silicone Chin Implants to patients in preference to other forms of chin augmentation as it is longer-lasting, safe and effective. Partial chin augmentation can be completed with the use of volumising fillers (e.g. hydroxyapatite, Radiesse) however these offer a temporary result and need repeating. Other volume augmentation including fat is less predictable and less effective for replacing boney deficiency. Other implants including Medpor and Polytetrafluoroethylene (ePTFE) are available, however are associated with a high risk of infection and integration with soft tissues compared to silicone. The surgical use of jaw sliding (genioplasty) is more invasive and associated with longer recovery and risk of nerve injury. A silicone chin implant should last a lifetime, rarely they can move or become infected, and can easily be removed in these rare occurrences.

How long is the recovery from a Chin Implant?

The results of the surgery are immediate, although local swelling can make the chin look too large for the first week. The swelling and local bruising takes about 1 week to mostly resolve, and the great majority of patients return to work after one week. There is a small incision under the chin and the sutures are removed after approximately 1-week. Patients are advised to take a soft food diet for the first couple of days and to avoid strenuous activity 3 weeks after the chin implant. Most patient have minimal if any pain, which responds to oral analgesia.

View Before and After Chin Implants photos

*Results May Vary

What are the risks or complications of a Chin Implant?

All cosmetic surgery has some risks, generally speaking chin implant surgery is very safe. With chin surgery there is a small risk of infection, bleeding, allergy, movement of the implant and of bone absorption over time under the chin implant. Dr. De Silva advises against chin surgery in patients with increased risk of infection.

Dr. De Silva uses technical skills to reduce the risk of implant movement or dislocation, by sculpting a narrow and deep pocket for insertion of the chin implant under the facial muscles that make movement of the implant minimal.

Dr. De Silva has treated patients with rotated chin implants by other surgeons, and uses a novel technique to prevent implants rotating in his patients by securing all implants with a specialized mini-screw. This screw is approximately 8mm in size and prevents any movement of the chin implant long-term. The screw is specialised and cannot be seen or felt once in place, it is not detectable on airport security although would be seen on an x-ray or CT scan of the head.

Watch Video: How is a Chin Implant Surgery completed? Dr. Julian De Silva customizes & sculpts each implant
How is a Chin Implant Surgery completed? Dr. Julian De Silva customizes & sculpts each implant...

What does Dr. De Silva do differently?

Dr. De Silva specialises only in the face and does not perform body surgery. With chin augmentation, the shape and size of the implant needs to be tailored to the individual so the result looks natural, complements the face and is long lasting. The appearance and strength of the jaw line is different in both men and women and this requires tailoring the individual implant. Dr. De Silva uses high quality silicone implants made in California that are shaped to the individual’s jaw line, this enables the implant to be harmony with the person’s face. Dr. De Silva’s techniques enable a precise operation with minimal discomfort. Dr. De Silva has removed implants from other surgeon’s due to the implant being both out of balance with and individual’s face or moving out of place.

The images on the left are taken a patient who had chin implant surgery in Eastern Europe, Dr. Julian De Silva performed revision chin implant surgery to remove the unsuitable implant and insert a tailor-made implant that gave a natural looking aesthetic. In this woman in her 20’s the implant that was inserted abroad was too large for the woman’s jaw line, and without being secured moved after the surgery resulting a box shaped chin. The green marks show the natural jaw line and the red marks show the position of the chin implant that was inserted in Eastern Europe, the implant is too large for her jaw line and is positioned below her jaw line.

On the before and after photos on the left, Dr. De Silva removed the previous implant, inserted a high-grade silicone implant that was tailor-made to the patient’s jaw line and facial shape, the implant was secured with two mini-screws to maintain the position of the implant long-term. The left photograph shows the before appearance with a long and box-shaped chin and the right photograph shows the more feminine and heart-shaped appearance 1-week after surgery.

Xray photos: Woman's face, before and after chin implant treatment
Woman's face, before and after Chin Implants treatment, front view, female patient 2

*Results May Vary

What type of anaesthesia do I need for a chin implant?

Chin augmentation can be completed with local anaesthesia, Dr. De Silva prefers his patients to have sedation anaesthesia, also known as twilight anaesthesia, this enables his patients’ to have a comfortable and relaxed experience with a fast recovery. With sedation Dr. De Silva’ s patients are able to go home within 30 minutes after the procedure. General anaesthesia can be used for chin augmentation it is not necessary as the recovery is longer.

Can a chin implant be removed?

The removal of chin implants is dependent on the type of implant that has been inserted and its method of fixation:

  • Silicone implants are relatively straightforward to remove. Non-silicone implants including Medpor (High-Density Porous Polyethylene), Hydroxyapatite, mesh and Teflon (Polytetrafluoroethylene) are more difficult to remove as the become integrated with the chin (scarring develops that makes these implants more challenging to remove)
  • Chin implants can be fixated by different means, commonly with stitches that can be removed.

Removing the chin implant completely is one option, this may result in a relatively weak chin. Dr. De Silva has removed the implants of other surgeons and if the chin was previously recessed, inserting a smaller implant with an improved and tailor made shape and optimal position may be a preferred option.

Reviews

5.00 from 426 reviews

By C, Chin implants, signature liposuction and neck stitches on Jan 18, 2020

I had chin implant + neck liposuction 9 months ago with Dr De Silva and confess I could not have done a better choice. First time I did any kind of surgery and confess I was very scared in doing it, especially doing something in my face. Since the start Dr. De Silva was very calm and patient which made me very comfortable. The staff are very helpful and amazing. The whole procedure was carried out under sedation and local anesthetic. The anesthesiologist was perfect explaining all the stages (especially for me who is very afraid of needles). I would fully recommend 100% Dr. De Silva. After the procedure I became much more confident person and my life got so much better. Didnt have any pos-operation problems and the result couldnt be better. It looks so natural. The whole experience was perfect
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By CI, Chin Implant with jaw line fillers, experience with Dr. De Silva on July 6, 2019

I recently underwent a chin implant with jaw fillers with Dr. Julian De Silva, I have had such a wonderful experience and was very well looked after right from my very first consultation. All of his team are super friendly and always available for any questions that I had. The surgery lasted about an hour under sedation which was a pleasant experience where I woke up to feel rested and was able to go home after 30mins. 5 weeks after the surgery I am so happy with my result, looking very natural but for me a great improvement. I highly recommend Dr. De Silva and I would definitely use him for any facial surgery in the future.
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By Chin Implant experience on Jul 20, 2019

I recently underwent a chin implant procedure with Dr. Julian De Silva. The surgery lasted about an hour under twilight anesthetiser. The sedative anesthetiser offers compromised local and general anesthetiser which was a very pleasant experience where I woke up to feel rested and was able to go home after 30mins. Six weeks later the results are startling I’m delighted with the results. I would highly recommend Dr. De Silva and I would definitely use him for any facial surgery in the future.
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Read More Reviews Here *Results May Vary

Does a chin implant look and feel natural?

The chin and jaw line are important characteristics in male and female faces and if weak or recessed can result in facial imbalance. With chin augmentation care must be give to the chin augmentation so that it is natural looking:

  • With chin augmentation, insertion of too large an implant results in a box shaped or unnatural looking appearance to the chin that is not attractive. There is a degree of artistry with chin augmentation procedures, Dr. De Silva has removed and replaced chin implants that are too large, too wide or too low from other surgeons.
  • A chin implant can be tailored to an individual’s jaw line depending on their facial characteristics.
  • All surgeon’s have a particular style and chin augmentation requires artistic interpretation in addition to surgical technique to give the best possible result, these can bee see with before and after photographs. Artistic judgement is a key characteristic in giving patients best possible results.
  • Seeing Patient’s Testimonials from previous patient’s experience can be useful, and ask if it is possible to speak to a patient who has undergone the procedure with the surgeon.
  • Ask to see Simulated Results: Your surgeon should analyze your pre-operative photographs with you and be able to show you their intended results. Modern computer imaging enable patients to be shown predictable after results with computer morphing software.
Watch Video: Dr. Julian De Silva - West London Chin Implant Revision & Patient Testimonial
Dr. Julian De Silva - West London Chin Implant Revision & Patient Testimonial

*Results May Vary

Do I need chin augmentation or jaw advancement surgery?

The chin and jaw line are important characteristics in male and female faces and if weak or recessed can result in facial imbalance. Chin augmentation can be achieved by several methods:

  • Chin augmentation with a chin implant requires a surgical procedure to insert the chin implant, however the size of the implant can be tailored to the individual and the implants will last long-term.
  • Augmentation of the chin with jaw advancement surgery (termed sliding genioplasty) requires more invasive surgery than insertion of a chin implant. Often the treatment is coupled with orthodontics requiring braces to realign bite that requires many months of treatment, there is numbness in the area of the jaw after treatment which can be permanent.

For most individuals Dr. De Silva augments their chin with a high-grade Californian silicon chin implant which is safe, effective, offers fast recovery and long-lasting. There is a degree of artistry with chin augmentation procedures and a chin implant can be tailored to an individual’s jaw line depending on their facial characteristics.

Watch Video: Chin Implant in West London with Dr. Julian De Silva - Sedation Review & Patient Testimonial
Chin Implant in West London with Dr. Julian De Silva - Sedation Review & Patient Testimonial

*Results May Vary

Can non-surgical Radiesse be used for chin augmentation?

Non-surgical augmentation of the chin with fillers (hyaluronic acid, Radiesse) offer a conservative augmentation that is temporary for between 6-12 months. Fillers are generally softer materials so the augmentation of the bone along the jaw line is generally limited in effectiveness. They offer the advantage of a non-surgical procedure that enable a patient to “try out an improvement” before surgery.

Chin augmentation with a chin implant requires a surgical procedure to insert the chin implant, however the size of the implant can be tailored to the individual and the implants will last long-term.

Simulated results with modern computer imaging software will enable you to see predicted results of the surgery. Your surgeon should analyze your pre-operative photographs with you and be able to show you graphically their intended results.

What are my options for improving a week jaw line?

The chin and jaw line are important characteristics in facial harmony and if weak or recessed can result in facial imbalance. Chin augmentation can be achieved by several methods:

  • Non-surgical augmentation of the chin with fillers (hyaluronic acid, Radiesse) offer a conservative augmentation that is temporary for between 6-12months. Fillers are generally softer materials so the augmentation of the bone along the jaw line is generally limited in effectiveness. They offer the advantage of a non-surgical procedure that enable a patient to “try out an improvement” before surgery.
  • Chin augmentation with a chin implant requires a surgical procedure to insert the chin implant, however the size of the implant can be tailored to the individual and the implants will last long-term.
  • Augmentation of the chin with jaw advancement surgery (termed sliding genioplasty) requires more invasive surgery than insertion of a chin implant. Often the treatment is coupled with orthodontics requiring braces to realign bite that requires many months of treatment, there is numbness in the area of the jaw after treatment which can be permanent.

Non-surgical treatments have a fairly limited effectiveness and are only useful for a mild augmentation of the chin for a temporary period. For most individuals the insertion of a chin implant is generally effective and long-lasting. With chin augmentation, insertion of too large an implant results in a box shaped or unnatural looking appearance to the chin that is not attractive. There is a degree of artistry with chin augmentation procedures and a chin implant can be tailored to an individual’s jaw line depending on their facial characteristics.

Watch Video: Rhinoplasty Review, Selfie & Testimonial
Rhinoplasty Review, Selfie & Testimonial

*Results May Vary

Can I have numbness after chin augmentation?

Chin augmentation requires surgical placement of the implant along the lower edge of the jaw. The nerves that provide sensation to the lower teeth, lips and chin area are positioned approximately 1.5cm from the lower edge of the jaw line. With chin surgery there can be stretching of the nerve with bruising and swelling that results in a degree of numbness soon after the surgery. As the swelling improves the sensation usually resolves over a few weeks, occasionally months. With good surgical technique the nerves can be avoided and numbness after surgery is generally uncommon and temporary.

How long does pain or numbness last after chin implant surgery?

Most patients have minimal numbness that resolves within 1 week of surgery. Relatively few patients may have numbness after chin implant surgery that takes 6-8 weeks to resolve completely. Stretching or swelling of the nerve that supplies sensation to the lower lip can result in this numbness as part of the surgery and as this swelling resolves the numbness fades. Very rarely numbness does not improve and may be the consequence of the implant lying too close or at the sensory nerve, this may occur because of the location or size of the implant or unusual anatomy of the nerve, in these exceptional circumstances the implant may need to be further reduced in size.

Dr. De Silva takes care to avoid the sensory nerve with chin augmentation surgery, by marking the anatomy of the nerve before surgery, caution with additional time during the surgery and shaping the chin implant.

For more information on Chin implants, click on the following links

Before & After

Woman's face, before and after chin implant, treatment photos, front,side,oblique face photos - female patient 1

*Results May Vary

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