Would chin augmentation effectively deproject this nose? (photos)

Question

Would chin augmentation alone will be sufficient to effectively "deproject" the nose on profile view? Can the bulbous tip also be reduced even though my nose has somewhat thick skin? The nose appears a little short on profile view. How does this influence the procedure? Finally, can the slight asymmetry in the frontal view be corrected as well?

Manish H. Shah, MD, FACS · Answer

Hello,Thanks for your question. You do have a slightly short chin, so chin augmentation would be helpful. It might not camouflage an over-projected nose much though. The end result would more likely be that your lips now look underprojected because of the lack of balance with your nose and chin. A chin implant and deprojection rhinoplasty makes more sense if your goal is overall facial harmony.As far as the rhinoplasty is concerned, while the tip is being deprojected, it needs a mild amount of derotation to elongate the bridge, and the columella needs to be extended just a bit. A septal extension graft is ideal for this. The mild C-shaped septal and nasal bone deviation can be improved but unlikely perfected. The reason for this is that you have significant asymmetry in multiple other areas of your face. These things can be improved, but again, not perfected. I would recommend that you consult with a rhinoplasty specialist in your area for more information.Good luck,Dr. Shah

Sam Rizk, MD · Answer

Hello, thanks for sharing your concerns and photographs. Since your chin isn't very defined, chin implants could balance your facial features. The size of a person’s chin tends to magnify or minimize the perceived size of the nose, disrupting facial harmony. Chin surgery helps improve facial harmony and correct a degree of asymmetry. In my experience, many patients benefit from computer imaging which shows you realistic results before committing to a chin implant/chin augmentation. For a more personalized consultation, you should meet with a board-certified facial plastic and reconstructive surgeon.

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam your question cannot 
be answered.  You will need to see an Oral/Maxillofacial surgeon to see 
if othognathic surgery, genioplasty or using an implant is best for your
 specific case. It should be noted that patients with severely weak jaws
 or abnormally functioning jaws may be better treated with other facial 
surgery (orthognathic surgery), although a chin augmentation may be an 
option at a later time. These patients should seek the advice of a 
plastic surgeon to determine which course is right for them. Here is 
some information to help you make this decision: Candidates for Chin 
Augmentation - Patients whose chin profiles are weak but have normally 
functioning jaws are candidates for Chin Augmentation. Many of these 
candidates have used injectable fillers in the past to strengthen the 
protrusion of their chins, but are looking for a permanent solution. If 
you are one of these patients, then you are a likely candidate for chin 
augmentation
#weakchin #chinimplant

Edwin F. Williams, III, MD · Answer

Good question! It is difficult to assess from your pictures but in someone who has a weak chin, a chin implant can effectively make the face look more proportional. It is possible to refine the tip in patients with thicker skin and there are different techniques to make the nose look longer on profile view. I'd recommend consultation with a Facial Plastic and Reconstructive Surgeon. He or she can talk about the specific options and goals of surgery, as well as review imaging of what can and can't be done. Hope this helps!

Barry L. Eppley, MD, DMD · Answer

Any form of chin augmentation will change how one sees the size of the nose. Computer imaging can demonstrate that to you. But it will not improve the thickness of the nasal tip or any asymmetries of the nose...issues which are not appreciated in the profile view which is most frequently used int computer imaging. Combining rhinoplasty and chin augmentation is common and powerful profile changing surgery. The change in the chin may affect certain aspects of how the rhinoplasty is done in terms of making the nose smaller or deprojecting the tip.

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

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin and lip), rhinoplasty, liposuction and/or facelifts for over 30 years. From the photos, your chin is quite weak as are the mandibular angles.  The nasal tip is over-projected (sticks too far off of the face) and is slightly over-rotated (makes the nose appear short).  In addition the tip itself is asymmetric with one tip cartilage sticking up higher than the other side. 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.  This will decrease the over-projected look of your nose but I'm not certain that it will remove it completely.   You may require a tip pasty along with a technique that decreases tip projection with localized procedure.  If your tip wasn't over rotated, you could undergo an open tip-pasty however, since it is over rotated I personally would avoid that approach.
Hope this helps.

Would chin augmentation effectively deproject this nose? (photos)

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