The shape and proportion of the bones of the face are important in achieving a pleasing overall facial harmony.
Over or under-development of the chin may occur on its own or be associated with problems with the size of the jaw-bones (mandible and maxilla). It is often possible to treat problems simply by changing the size and shape of the chin, but more severe chin or jaw disproportions may require more complicated treatment and may involve orthodontics and surgery to re-align the teeth and jaws.
Many procedures are available to change the shape of the chin and to decide on the best treatment. Firstly, a facial analysis is taken, which involves a simple analysis and morphing of digital photographs of the face. This can be undertaken at your consultation. Occasionally, more complex problems require an X-ray or cone beam CT scan to show the shape of the underlying facial bones.
Procedures
Chin Reduction
A prominent chin can often be reduced by removing some of the chin bone in a procedure called a Reduction Genioplasty. The procedure is undertaken through an incision in the mouth. This is an excellent technique for small reductions, however a mandibular osteotomy is required for more severe problems.
Chin Augmentation
There are many ways to reshape and increase the size of the chin.
Fat Transfer – Very small increases in chin size can be achieved by autologous fat injections (using your own body fat). This is simple procedure and is commonly used in conjunction with other procedures, such as a Rhinoplasty and Facelift.
Chin Implants – Preformed chin implants are made of several materials and our surgeons usually use Medpore or occasionally silicone. The procedure is fairly minor and can be performed under general anaesthesia or local anaesthesia with sedation. Implants are usually inserted through a skin incision under the chin, rather than through the mouth in order to reduce the risk of infection.
Custom Made Chin Implants – These very modern implants are engineered to precisely fit the bones of your chin using information from a CT scan. The computer-assisted design ensures that the implant is exactly the correct shape. Custom-made implants are usually made from PEEK.
Genioplasty – This operation involves making a cut in the bone of the chin below the level of the teeth and advancing the existing bone of the chin. The operation is undertaken from an incision inside the mouth and a small titanium plate is used to fix the chin into its new position.
Each of these operations is carried out through an incision inside the mouth between the lower lip and gum. More severe chin or jaw disproportions may require more complicated treatment and may involve orthodontics and surgery to re-align the teeth and jaws.
Many procedures are available to change the shape of the chin and cheeks and brow. In order to decide on the best treatment, it is usually necessary to perform an analysis of facial proportion. This often involves a simple analysis and morphing of digital photographs of the face, which can be undertaken at your consultation. Occasionally, more complex bony disproportions require an x-ray or CT scan to show the shape of the underlying facial bones.
Frequently Asked Questions
If the operation involves incisions within the mouth, it is important to have a dental check-up before surgery and often a visit to the dental hygienist is advisable.
You should not take aspirin or non-steroidal anti-inflammatory drugs such as Brufen or Nurofen for two weeks before your surgery. These drugs increase the risk of post-operative bleeding and have an adverse effect on bruising.
If you smoke, you will need to stop smoking for two weeks before surgery and a week afterwards. Smoking reduces the blood flow to the skin and can prevent healing.
Surgery is usually performed under general anaesthetic and there is a small risk of chest infection, especially among smokers. Numbness of the lower lip may occur depending on the area operated on and there is a very small risk of weakness in some of the muscles of the mouth. There is also a small risk that an implant or genioplasty can damage the roots of nearby teeth. Occasionally, implants can become displaced, but fixing implants with small titanium screws reduces the risk of this. All operations carry a small risk of infection. If there is a significant infection, the implant will need to be removed by surgery.
Consequences of surgery – Surgery to the bones of the face usually produces some swelling and bruising, which may take several weeks to settle. Temporary numbness of the chin, lips and cheeks can occur following surgery to these areas. It usually disappears within a few days, but occasionally prolonged numbness can occur.
Insertion of bone grafts and implants inevitably carries a small risk of infection, although happily this is uncommon. Very occasionally, chin augmentation can cause an unnatural crease when smiling.
Limitations of surgery – It is usually possible to harmonise facial features with one or more of these operations, however, there are some limitations to the way in which the shape of the bones of the face can be changed. The use of computer prediction software and alteration of digital photographs will help in the planning and explanation of the expectations of surgery.
These operations are almost always undertaken under general anaesthetic and usually require an overnight stay. You can expect a moderate amount of soreness and discomfort in the first two days. Following the operation, it is usually necessary to sleep for the first night with the head of the bed raised to reduce the swelling. It is also important to keep your mouth clean. Mouthwashes will be provided and it is important to take care not to touch the stitch lines whilst brushing teeth. Following your procedure, your surgeon will ask you to book an appointment one week post-operatively for removal of any non-dissolvable sutures. If you need pain relief, you can take over the counter painkillers, such as Paracetamol or Ibuprofen. It may take 24 hours to recover from your anaesthetic. During this time you should not drive, drink alcohol, operate machinery or sign any important documents.
If you have any concerns after your procedure, you should contact the office or our emergency number outside normal working hours for advice. If you find that your swelling, redness or pain gets worse or if you develop a high temperature, it is important to contact us as soon as possible at the practice.
