What are the pros and cons for both? Why would one doctor choose outside chin and another inside mouth. If you had a chin implant via an incision under the chin and you need to do a revision. Should the doctor make incision under the chin as well? Which is safer?
When Getting a Chin Implant is It Better to Do Incision Via the Mouth or Under the Chin?
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Method of Chin Implant Placement
Chin implants are typically made of silicone and commonly used either alone or with other facial plastic surgery procedures. Rhinoplasty and facelifts are the more common joint cosmetic procedures. Implants may be placed via small incision inside the mouth (intraoral) or under the chin (extraoral). Both approaches are appropriate techniques. The specific decision on the approach is based on other procedures which may be performed at the same time, along with patient & surgeon preference. Plastic surgeons typically perform both approaches as needed.
For example, an older woman with facial aging, a weak chin, neck fat, and sagging skin will typically have a chin implant via an small external incision along with her face lift surgery, since the plastic surgeon most likely will be using a chin incision already to improve the neck contour.
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External vs Internal approach for Chin Implant placement
Chin implant Incision inside the mouth or under the chin
This comes down to training and experience. Clearly the single primary advantage of placing the incision inside the mouth is the advantage of concealing the scar whereas the disadvantage is placing an implant through likely the most contaminated part of the human body with the potential increased risk of infection as well as the possible disinsertion or disruption of the mentalis muscel. The advantage of placing it under the chin is the cleaner anatomic path but the disadvantage of a potentially more visible incision.
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Better to place chin implant via incision under the chin
Placing a chin implant through an incision under the chin is the best way to perform chin augmentation. There is a lower risk of infection, the implant is less likely to migrate and there is no need for a screw.
Not only is infection more likely to occur when the implant is placed through the mouth, the implant tends to move upwards away from where it was originally placed.
Either surgical approach is acceptable.
You are asking well thought-out questions. In my opinion, if a young patient is having a chin implant, I prefer an intraoral incision, so there is no visible scar. If I am planning a chin incision anyway, like for a facelift or neck liposuction, then I place the implant through the skin incision. The scar in the chin is generally very acceptable cosmetically.
Intraoral versus External Incision for A Chin Implant
Both approaches have their merits. An external approach allows for more accurate placement of silastic implants with less potential contamination of bacteria from the mouth. Intraoral incision avoids an external incision at the theoretic risk of bacterial contamination and less accurate placement of solid state implants.
Approach for Chin Augmentation With An Implant
My personal preference is to use an external incision for placement of a chin implant. I still believe that it is a more sterile approach than using an intra-oral incision. I also feel like placement is more accurate in my hands with an external incision. My surgical dissection allows a more direct visualization of the lower border of the jaw and affords me a more accurate placement. As others have highlighted, this incision made under the chin heals so well that it is barely perceptible once healed.
Chin implant approaches
My personal preference for placing a chin implant is to go through a small incision below the chin. The advantage of this approach is that a larger anatomic chin implant can be placed right along the jaw line. Also, if it needs to be removed or replaced or revised, this is more accessible this way. The other advantage of this approach is that you stay away from the nerves that are responsible for sensation of the lower lip and there is a lower infection rate. Finally, implants that are placed via the mouth can ride higher and are more easily displaced in my opinion.
Chin implant incision choice
Both the intraoral and external incisions are acceptable and I perform the procedure from both approaches. However, each patient is different and one must take into account the anatomy, the size of implant, the particular patients healing potential and the desires of the patient. Having said that, I performed an intraoral incision for most patients during the first 10 years of my practice, but had 3 get infected from bacteria in the mouth. In most cases today, I prefer the external incision as the approach is direct, and I have had zero get infected by avoiding the intraoral bacteria. Discuss your concerns with your surgeon to arrive at the best choice for your individual needs.
Chin Implant incision
Both the intraoral and submental incisions do very well. It is really a matter of preference of the surgeon. I prefer the intraoral incision since the attachment at the edge of the jawbone is not disturbed. At one time I worried about contamination, but many studies have shown no increase in infection rate over the submental incision.
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