Chin implants are important part of rhinoplasty. In about 4 out of 10 patients who undergo rhinoplasty require chin implants as well. Now, when I say require, obviously, it is elective surgery, it’s nothing that’s absolutely necessary, so if a patient comes in and complains that the nose is projected too much, that it’s too long, and their chin is actually too weak, you have to be able to demonstrate that issue to the patient, and computer imaging becomes very important part of this. So, if the nose looks too long but it’s not necessarily that long; however, the chin is much, much weaker, then to make the nose fit the face and be balanced more, you have to bring the chin up a little bit.
Now, there’s different variations of this and getting computer imaging on the video screen will show patients exactly what we’re discussing. It’s up to them whether they want to get a chin implantation or not, but you can’t make the nose that small to fit a very weak chin, so chin augmentation becomes an important part of balancing the face in about 4 out of 10 patients undergoing rhinoplasty. We talked about the past and I’ve blogged this a lot on the internet, about the different forms of chin implants, there’s various forms, there’s medpore chin implants, silastic chin implants. There’s actually ways of cutting the bone, the chin bone, and moving the chin forward, and other various techniques.
My technique is a little bit different. It uses mersilene mesh and it’s hard for patients to visualize what this mersilene mesh is. We’re going to talk about a little bit of the advantages and disadvantages of each. The different form of chin implants come in different forms, and shapes, and sizes, and I’m going to show you essentially, the silastic ones and the advantages and disadvantages of those. And then, we’re actually going to make a certain chin implant with mersilene mesh today and you’ll be able to visualize.
What I have here are three different forms of silicone chin implants, and you can see that they come in pre-made shapes and sizes, and they’re soft. You can even trim them to a certain amount, and the different dimensions that are important are the thickness; basically, how much augmentation needed, the anterior posterior dimension, the width in this dimension or the height of the chin implant, as well as the width in this dimension or basically from side to side. And you can see that again, there’s different forms, and shapes, and sizes.
Now, the advantage of these are that they are pre-made, and it’s very simple to obtain these and pop them into place. The disadvantage is that they can shift, they can move, and you can actually feel the edges of them. And especially in women, they make the chin a little bit too square, and little bit too masculine, and I just don’t personally prefer this kind of thing. I’ve never seen one that looked really natural especially in women. I’ve never seen one that looks very feminine and again, when you feel the edge of them on your chin later on, pretty much forever and ever, you can feel the edge of them, and they can shift and move. Also, surgeons prefer to squeeze this in, some basically suture them in. But the advantages of these is that if they become infected, and all implants have a risk of infection, they’re very easy to remove.
Now, these thing, shapes, and sizes also come in material called medpore. Medpore is a porous substance, it goes in; it has all the same disadvantages of this, with the additional disadvantage that it’s extremely hard to remove. What I prefer is to make my own chin implants, and when I make my own chin implants, I use a material called mersilene mesh. This is a surgical mesh. It’s very soft cloth, and you’ll be able to see exactly what I’m going to do with it today.
So, what we do to start with, is take a package; it comes in a 12 x 12 inch package. I open it up and I’ve opened this one before, and this is the material. And you can see that essentially, it’s a mesh, it’s like a cheese cloth. However, the surgical mesh, general surgeons use this is for repair a crania and other places in the body. But what I’m going to do is I’m going to show you essentially how you make the chin implant. I have little cardboard cut-outs depending on the patient’s size and stature, and even it’s arbitrary. Essentially, it’s got a rectangular shape and what I do is I take the first one, and I start rolling it up. So I start wrapping it around this, little by little by little, giving it width, and it just depends on how much width I need.
A Chin Implant Augmentation Often Accompanies a Rhinoplasty
Dr. Shervin Naderi explains why a chin implant augmentation may be suggested alongside a rhinoplasty and demonstrates why and how he prefers to make his own.