* Reviews

Chin Implants

Dr. Yaremchuk uses innovative techniques and implant design to ensure ideal results for each chin augmentation patient. While chin implant surgery has long been touted as a simple operation that reliably gives good results, Dr. Yaremchuk believes that conventional techniques often produce aesthetic results that are less than ideal. The result may be compromised by the preoperative analysis, the surgical technique, the implant design and the patient’s physical response to the implant material.

When surgeons plan chin augmentation, they should calculate the prominence of the chin considering several variables: sex, the effect of occlusion on lower lip position, the thickness of the chin pad, and the depth of the labiomental fold. When these variables are not considered, implant augmentation may result in a chin that is unnatural and too large, particularly in a woman.

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This diagram is adapted from the work of medical anthropologist Leslie Farkas and his coworkers, who captured facial measurements of various populations of both sexes to understand average features by race and ethnicity. The picture on the right shows the average profile of a young North American Caucasian female. The chin point lies an average of 4.1 degrees behind a perpendicular dropped from the glabella (lower forehead). At 1 standard deviation (SD) (the area colored in orange) the chin point still lies behind the perpendicular line (dashed line) dropped from the forehead.

The picture on the left shows the average profile of a young North American Caucasian male. It demonstrates that men have more prominent chins than women do. However, only at one standard deviation (the range most common within the total population) does the chin point meet the perpendicular (dashed line) dropped from the forehead. These measurements show the differences between women's and men's faces and help explain why implants that are too large may be interpreted as unnatural and may masculinize a woman's face. These anthropometric measurements provide valuable insight but should not act as absolute guidelines for chin surgery.  In any individual patient, greater or lesser chin projection may be appropriate to create the best “balance” for that face.

Chin augmentation with certain shaped implants can create unnatural chin contour. Implants that augment only the chin point, rather than the jaw-chin continuum, produce an abrupt, protruding chin.

This patient, who came to Dr. Yaremchuk to correct prior chin implant surgery, shows how a large implant that augments the chin point only can create an unnatural 'stuck on' appearance.

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Extended one-piece implants, another traditional implant design, do not always match the contour of a patient’s mandible. Particularly when placed through small intraoral incisions, minimal inaccuracies in placement or asymmetries in the midaspect (chin point) of the patient’s mandible may result in gross distortions and irregularities in the appearance of the chin.

The diagram below demonstrates this complication. The clinical example on the right illustrates the resultant distortion in mandibular contour. The arrow points to the distal end of the chin implant which extends over the edge of the patient’s mandibular border.

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Dr. Yaremchuk has designed a two-piece implant which helps to avoid some of these problems.  Because the implant consists of right and left components that are hinged in the midline, the edge of the implant can be matched more closely to the mandible border.

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In addition, the implant is designed with tabs used to attach it to the mandible, which assures symmetry of implant placement.

Chin implant surgery should respect the skeletal differences (sexual dimorphism) inherent in male and female faces.

Note the narrowed, tapered shape of the chin in this female skull.

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Its shape is quite different than the broad, flatter shape seen on the male specimen.

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To respect sexual dimorphism, Dr. Yaremchuk designs chin implants with both female and male shapes. The implants on the left imitate a female chin contour, while those on the right mimic the male chin contour.



Below are examples of chin implant surgeries performed by Dr. Yaremchuk.

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* This patient underwent chin augmentation, submental lipectomy (removal of fat beneath the chin) and buccal lipectomy (removal of fat from the lower cheek) to improve facial contour.

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* This patient underwent chin augmentation with a porous implant.

 

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* This patient with long face syndrome underwent chin shortening, chin augmentation and posterior mandible augmentation.

 

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* This patient underwent chin augmentation and submentallipectomy

 

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* This patient underwent sagittal osteotomy of the chin to lengthen it and a porous polyethylene implant to increase its projection.

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* This patient with micrognathia underwent chin and mandible augmentation

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* This patient underwent chin and mandible augmentation as well as submental lipectomy

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* This patient with a long face had her chin shortened and also augmented with an implant. She also had a rhinoplasty.

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* This patient underwent chin augmentation and submental lipectomy

 

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* This patient underwent chin augmentation

 

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* This patient underwent chin augmentation

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* This patient’s microgenia was corrected by increasing the vertical height of the chin with a lengthening horizontal osteotomy and augmenting the chin and mandible with implants.

 

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* This patient underwent chin augmentation

 

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* This patient desired slight chin shortening,and sagittal augmentation.

 

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* This patient underwent chin augmentation and rhinoplasty.

 

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* This patient developed a capsule outlining a small silicone implant. It was replaced by a porous plyethylene implant. A small posterior mandible implant was also placed to improve facial balance.

 

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* This patient underwent chin and jaw augmentation.

 

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* A patient underwent chin augmentation.

 

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* The patient had a sliding genioplasty in the past. The chin was shortened and recontoured with a porous polyethylene implant. The mandible angles were reduced.

 

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* The patient presented with an implant positioned below the inferior chin border. It was replaced with a appropriately positioned implant.

 

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* The patient underwent chin and mandible augmentation. Note how the increased chin projection balances the nose.

 

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* Another example of chin projection on nasal profile and submental contour.

 

Chin Implant Surgery Procedure