Francis R. Palmer, III, MD (retired)

 Hi, "button" chin implant is a term describing a smaller version of a curvilinear style chin implant that's still available.  These styles, in my humble opinion do not offer the same degree of aesthetic improvement found ion the extended anatomical implants.  

  I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  

 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  

 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  

 When consulting with surgeons perhaps ask not only is your chin weak but do they have experience performing chin augmentation?  The attached video shows how I determine whether the chin is weak.  The second part of what that surgeon said is absolutely correct.  The selection of the proper size, shape and thickness as well as the proper placement of the silastic chin implant are all "key" elements in creating a naturally looking chin.  If too large of an implant is used in a woman, the chin can look relatively masculine.  That's where experience, performing chin implant surgery, comes into play.

Hope this helps.

 Hi, at 7 days it's just too early to make an assessment of the final result.  It would be best for you to express and discuss your concerns with your chin implant surgeon.  The swelling is usually gone (or most of it is gone) at 1 month post op, so you still have 3 more weeks.  In my humble opinion, give yourself enough time to heal and see the final result.  If an intra-oral approach was used, the added tissue dissection will likely increase the swelling and healing time.

  I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  

 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  

 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  

Hope this helps.

Hi, from the photos these appear to be what I call "pseudo jowls" that occur from a lack of chin bony support in the area.  The photo shows that your chin, despite the dermal fillers, is still quite weak.  

I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  

 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  

 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  

 When consulting with surgeons perhaps ask not only is your chin weak but do they have experience performing chin augmentation?  The attached video shows how I determine whether the chin is weak.  The second part of what that surgeon said is absolutely correct.  The selection of the proper size, shape and thickness as well as the proper placement of the silastic chin implant are all "key" elements in creating a naturally looking chin.  If too large of an implant is used in a woman, the chin can look relatively masculine.  That's where experience, performing chin implant surgery, comes into play.

Hope this helps.

 Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  Non smiling, resting photos of your face from the front and side would help in the evaluation.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  

 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  

 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  

 When consulting with surgeons perhaps ask not only is your chin weak but do they have experience performing chin augmentation?  The attached video shows how I determine whether the chin is weak.  The second part of what that surgeon said is absolutely correct.  The selection of the proper size, shape and thickness as well as the proper placement of the silastic chin implant are all "key" elements in creating a naturally looking chin.  If too large of an implant is used in a woman, the chin can look relatively masculine.  That's where experience, performing chin implant surgery, comes into play.

Hope this helps.

 Hi, I am sorry but the limited photo doesn't show enough of your face and jaw line.  Non smiling, resting photos of your face from the front and side would help in the evaluation.  I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.

 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 

 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.

2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.

 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

• very small incisions and no incisions extend or are placed within the hair.
• minimal tissue dissection less bruising and swelling rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
• can be performed in 90 minutes or less, with or without general anesthesia
• proper SMAS Imbrication technique
• no incisions within the hair no hair loss
• excess fat can be removed from the face and neck
• excess skin removed from the face and neck
• cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
• most patients fly back home to parts all over the world in as little as 3 days post-op