The best candidate for a chin implant is the individual who has a normal bite but receding chin. Chin augmentation can also be a wonderful adjunct to rhinoplasty. It's all a question of facial balance. A receding chin can make a prominent nose look even bigger. Bringing the chin out ever so slightly while subtly reducing the nose is extremely effective. The two parts are in harmony. This is a difficult concept to portray without the use of a video imager, since most people don't see their own profile with any frequency. A synthetic preshaped form is inserted through a small incision inside the mouth between the lip and teeth or the skin surface just underneath the chin. A small, precise pocket is formed to accept the implant, much like a "hand in glove" fit. The most common materials are solid silicone (Silastic) or gortex. The material of choice according to Dr. Szachowicz is still silicone. "I feel silastic implants offer the texture which is closest to actual bone. It's had excellent results in over forty years of surgical use." Unlike the silicone breast implants which are gel filled and mobile, the silastic chin implants are dense and placed directly onto a bony surface. If correctly sized and placed, the chin implant does not move or shift and tissue reactions are rare. There are surgical alternatives to chin implants. These procedures cut into and move the jaw or chin bone itself. One is called a saggital split of the jaw (mandible), the other a genioplasty, moving the chin forward. The surgeon then slides the chin or jaw forward and the bone is secured in its new position with plates and screws. These surgical maneuvers put the sensory and motor nerves at a great deal more risk than mentoplasty, but can be appropriate for individuals with a severely misaligned bite. A few years ago, Carol Burnett decided to buy the chin she never had and opted for both the saggital split and genioplasty. Unfortunately, the surgery appears to have damaged her marginal mandibular nerve, a motor nerve to the lower lip. The result is that her trademark grin is lopsided now.