I have a weak chin and i might have a Bimax protrusion will getting a chin implant make my mouth look less protruded? and will it improve the definition of my jawline? also my nostrils are very round and they show too much is it possible to have a sharper nose that points forward (not upwards) and have less round nostrils? can rhinoplasty fix this? one last concern. it may not be that obvious but my lips are a bit tilted is there any way to fix this? would you suggest me getting anything else?
Chin Implants and Rhinoplasty? Which Surgery Would I Benefit from More or Should I Get Both (photo)?
Doctor Answers (9)
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Chin implant and rhinoplasty
A chin implant would be an excellent way to improve the overall projection of the chin area and make the mandible more in balance with the remainder of the facial features. The chin implant in addition to giving projection, will also give a slight amount of width and vertical height. A chin implant is inserted through a half-inch long submental incision and placed directly over the bone in a precise pocket so it will not shift. An alarplasty procedure will reduce the size of the nostrils through an incision at the floor of the nose, inside the nostrils. This incision heals quite well and is usually minimally detectable. The chin implant and alarplasty can both be performed under local anesthesia.
Jaw correction first
You should see an Orthonagthic surgeon first. They will examine you and do C T scans and decide as to what has to be done. If the Orthonagthic surgeon says that they is no problems, then see a board certified plastic surgeon for the chin and nose. Both can be done together.
There are a variety of options
Regarding your nasal concerns, there are definitely techniques available to project and strengthen your nose without turning it upwards. And you would likely see at least a perception of less rounding of the nostrils with such a procedure.
Regarding you chin, be careful just having a chin implant placed. You have very limited mandibular projection and poor vertical height, so if a chin implant is placed that is too large, it will look very unnatural. You should consider at least an evaluation for jaw surgery (orthognathic surgery), but a likely acceptable compromise would be a "genioplasty" (isolated chin bony surgery) whereby the chin would be brought forward and downward (or lengthened---this is perhaps the most important key to your being satisfied with your result).
Finally, when choosing a physician, the key is that your physician is experienced and can show you their favorable results for your type of situation. While "Board" certification is important, skill and talent is equally desirable..
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I would recommend that you make an appointment with a Board Certified Plastic Surgeon, certified by the American Society of Plastic Surgeons (ASPS) to discuss your concerns and expectations. You have several questions that will require an exam for the best advise.
Without an exam its hard to be exact, you should see a Certified Plastic Surgeon to give you your options. A chin implant sounds like it would give you a nice profile.
Chin and nose surgery
The problem that stands out the most is severe deficiency in chin projection, as well as jaw asymmetry. A bony chin surgery to increase projection will be in your best interest in both the short and long term.
However, I would imagine from reviewing your pictures that formal orthognathic surgery would likely accomplish your goals from an aesthetic standpoint - correcting both your chin and jawline. This would require orthodontic treatment, but would offer the best results.
I hope this helps,
Chin augmentation and or nose
A chin implant might do the most for you , at the least in cost and down time. If advancement of the mandible is done, the surgery is more complex and somewhat irreversible. An improved jaw line and projection of the chin can make the nose and lips look better. Have computer imaging done to see what these operations might do for you.
Chin Osteotomy vs Orthognathic Surgery
The most significant change you can make in your face is the projection of your chin. But an implant alone will likely not be inadequate due to the degree of bony deficiency that you have. You would ideally benefit from an osteplastic genioplasty (chin osteotomy) which can move the chin further forward and help your lower lip support. In addition, you have jaw asymmetry with a tilt to your entire jawline. This is also where an osteotomy would be better than an implant as the bone can be shifted to accomodate for the asymmetry. Given that you are young with a very short and asymmetric lower jaw, you should also consider exploring a combined orthodontic-orthognathic surgery approach which will deal with the underlying issue of severe mandibular deficiency in the most ideal manner. Chin osteotomies and jaw angle implants can be done if you decide that the orthognathicsurgery approach is more than you want to do.
You are a candidate for both rhinoplasty and chin augmentation
Both would be good options. If you had to choose one over the other a chin implant would provide a bigger improvement in the balance of your face. One important point to consider is that chin implant will not change your bite in any way. If you have associated dental problems due to a small jaw, you might be a good candidate for jaw procedure to lengthen the jaw, improve your bite and the appearance of the size of your lower jaw. I hope this information is helpful.
Stephen Weber MD, FACS