I'm looking for a stronger chin/jawline. Would I be better served with a silicone or porous polyethylene implant? (photo)

Question

I'm looking for a stronger chin/jawline. Would I be better served with a silicone or porous polyethylene implant? Would the PP give me better vertical height in addition to projection? Should I also consider lipo for my neck? I have spoken to two surgeons. One was adamant that porous polyethylene was superior to silicone chin implants. He also recommended some lipo to square my chin to my neck. Should I be concerned with my chin crease if I increase projection significantly?

Kenneth Hughes, MD · Answer

Silicone implants will lead to fewer issues, particularly if you need to have it removed one day.  Adjuvant liposuction can be reasonable as well.

Zoran Potparic, MD · Answer

I do not see a big difference in final result between these two types of implants. For that reason we almost exclusively use silicone implants (unless patient desire PP) in our practice. They are easier to place and easier to remove, if needed. They all come in sufficient number of styles and sizes to fit majority of patient needs. Whether liposuction or anterior neck lift would be better choice for you can be decided only on the basis on in person evaluation. Good luck.

Jonathan Kulbersh, MD · Answer

You have a few options to improve the projection and symmetry of your chin and profile. If you’re not sure you’re ready for surgery, but still want to improve and strengthen your chin, I’d suggest augmenting your chin with Sculptra and/or Voluma. If you like your new look, you can make it permanent with a chin implant. I hope that helps.

William Portuese, MD · Answer

In our practice, we use solid silicone chin implants for chin augmentation. The implants are manufactured by Implantech can be custom carved when necessary to match patient's unique anatomy. We do not recommend porous implants due to higher infection rates. The implants themselves give a three-dimensional augmentation which includes mostly forward projection, some lateral width, and a small amount of vertical height. Liposuction in the neck can accomplish improvement in the jawline underneath the chin.

Barry L. Eppley, MD, DMD · Answer

The material used in the chin/jaw implant is irrelevant. What matters is the design of the implant and whether it can create the look you want and fit onto the bone in an intimate manner. The other issue to be aware is that a chin implant is not going to make your jawline any better, that is beyond what it can do. As a chin implant it is improves chin projection but that is all. It takes a more more complete and extended implant to make a more 'defined jawline'. Liposuction also does not create a defined jawline, its purpose to help create a better cervicomental angle not a defined jawline

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin and/or lip implants), liposuction and/or facelifts for over 30 years.  Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  From the photos, your cheeks are flat in the front, there is excess fat in front of the cheeks as well as under the chin (very minimal amount), the chin is weak as are the mandibular angles.  The following procedures would create a more ruggedly handsome face.
Cheek augmentation with silastic cheek implants to add angularity to the cheeks and mid face.  Liposuction can be combined to reduce any excess fat to further shape the cheeks and face.
Chin augmentation, using a silastic chin implant, to add projection to the chin creating harmony and balance to the lower face.  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 bone segments).  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.  
Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.
 Silicone implants remain the "gold standard" and have many advantages over Porex type implants.  The most notable, is the ability to remove and or replace the silicone implant at any time and for any reason.  Similarly, there are many different styles and sizes of silastic implants which is why it's important to see a facial shaping expert surgeon. I prefer placement of a  silastic chin implant through a small, curved incision under the chin (submental) instead of through the mouth for the following reasons:
*The submental approach is sterile while the intra-oral approach is not.
*The submental approach requires limited dissection as it is much closer to where the chin implant needs to be placed along the center (front) and lower most sections of the chin on each side (where the wings are placed).  The intra-oral approach by contrast requires dissection all the way down the entire section of the chin in order to reach the same areas for chin implant placement.  The intra-oral leads to several issues in my humble opinion. In my opinion and experience there is no need to secure a silastic chin implants with sutures and screws when the following conditions are met:
 * Select a silastic chin implant ( I prefer the EAC) that doesn't have too much projection (thickness) as this becomes a problem stabilizing the implant under the periosteum when the implant is too thick.
 * Place the implant through a small curved incision under the chin which allows direct access to the periosteum (under the mentalis muscle) while preserving the muscle attachments.  This prevents upward migration of the implant which can occur when the intra-oral approach is used that severs the muscle attachments.
 * While the center or body of the chin implant should be placed at a perpendicular angle the chin bone in order to provide the proper forward projection to the chin, the "wings" of the implant should be at a lower level and follow the inferior (bottom) edge of the jaw line on either side of the chin.  When properly dissected and placed, this will be below the mental nerve foramen and be just wide enough of a dissection to accommodate the tapering wing.  There isn't enough room in this technique to allow the wings to migrate upward and contact the mental nerve.  In contrast if the dissection, along the sides of the chin (jaw line) are performed too high...this will place the mental nerve in danger and if the side dissection is too wide, the wings will have a space within which to migrate upward.
 * We have all of our chin implant patients avoid touching and feeling their chin implant for 1 month post op.  We also ask that they sleep on a U-shaped airline pillow for the same time.
  Our experience when following the technique described above is that the silastic chin implant does not need to be secured with sutures or screws and does not move.  I have placed silastic chin implants in military, SWAT, LE, professional fighters, as well as actors and many regular people who are active.  In addition, I have had the opportunity on numerous occasions to replace silastic chin implants (placed by others) that had been screwed into the bone.  During the replacement it was evident that the metal screws pushed right through the soft silastic implant as it was tightened down on the hard chin bone.  Which makes perfect sense.  So in the long run, these fixation methods alone are no guarantee that the implant won't move.  Proper placement, proper implant pocket creation and meticulous closure of all the tissues layers is what is required in my humble opinion.Hope this helps.

I'm looking for a stronger chin/jawline. Would I be better served with a silicone or porous polyethylene implant? (photo)

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