yes, you have a good perspective. IF you choose not to solve the lower jaw recessiveness, then when doing a genioplasty one must be careful to avoid trying to 'idealize' the profile with a 'chin only ' procedure. The look from the 'front' has to consider how 'tapered/narrow' the jaw is; or you end up with an unnatural look. Implants do not offer the 3D benefit of the sliding genioplasty, especially with respect to the fold. The sliding genioplasty can better adjust for the fold to avoid excessive deepening and also one can 'combine' a small implant under the fold with the sliding genioplasty, depending upon the lower incisor position
A chin augmentation would improve the profile immensely and would not be an odd extension on a receded chin. Computer imaging during consultation will be helpful to show you how the implant would look. The labiomental fold will not be a problem. Best regards, Michael V. Elam, M.D.
Given your photos, both an implant and a genioplasty are good options.
Discuss this with the surgeon you consult - based on the look you want and the surgeon's examination.
Hello and thanks for your question.
In our practice we use both options.
An exam is needed to assess the anatomy and discuss the pros and cons of chin implant vs genioplasty.
A chin implant would offer a nice benefit without much expense.
Kenneth Hughes, MD
Los Angeles, CA.....
On profile view you show a clear need for a chin augmentation. If the right chin is chosen and placed against the bone as it should be your result should be terrific. I see your concern about the lip chin crease but I still think you could tolerate a small chin implant and look totally natural. The procedure takes 20 minutes under local anesthesia in the office and is very easy to recover from. For patients with normal occlusion and no other facial disharmony I consider sliding genioplasties much more painful, much riskier and of no benefit over a simple implant placement. Implants come in all sizes and shapes and actually give you more to work with than a sliding genioplasty which has a long and painful recovery period. I, as like most plastic surgeons have done hundreds and hundreds of implants and very few sliding genioplasties.
The primary goal of a chin implant is to give forward projection of the mandible and accentuate the jawline. The secondary goal is to give a slight amount of width and added height to the chin area. Chin implants are manufactured in a variety of sizes and shapes which is best determined at the time of the consultation and examination. a chin implant is inserted under local anesthesia through a sub mental approach.
It is important to remember that the labiomental fold is a fixed structure, it is not going to be brought forward whether you use an implant or a sliding genioplasty. The depth of the anterior mandibular vestibule (which is the primary source of the fold) will not change as the chin is brought forward. There are several strategies to deal with a deep labiomental fold in large chin augmentations including limiting the amount of the augmentation, keeping the implant low or opening a sliding genioplasty slightly and simultaneous fat grafting to the labiomental fold with the chin augmentation.
As you suggested the chin implant is an easier procedure and will give you the desired result. The mental crease will not be a problem if the work is done by an experienced surgeon.
If you are not planning any future orthodontic procedures that might affect your result then all the procedures you have mentioned are excellent. If you are planning future orthodontia then incorporating a genioplasty or osteotomy into that plan would be logical after cephalometric analysis. Otherwise a chin implant is certainly easy