Deciding between a sliding genioplasty or chin implant. Any suggestions? (photos)

Question

I've posted a few times, so forgive me if my face looks familiar, but I'm opting for chin augmentation later this month and really trying to decide whether a better aesthetic outcome would be achieved through the use of a chin implant or sliding genioplasty. Two surgeons have recommend a SG (both oral/max surgeons) for increased height and projection and two plastic surgeons have both recommend a large extended anatomical silicone implant alone. Could I get some feedback from doctors who do both?

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

Without an exam your question cannot be answered. However, your photos are helpful and you are probably a good candidate for a Chin Augmentation. 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.Intended ResultChin augmentation most often is used to restore balance to the face due to a weak chin (under-projecting in profile). This disproportion of facial structure—having a small chin—tends to make the nose look larger and results in a poor jaw/neckline. As it doesn’t support the neck skin, often it causes skin to hang down from the upper neck and can lead eventually to a “turkey waddle” deformity. Chin implants can also create a wider, stronger chin. They can also be used to lengthen the face slightly.The augmentation is performed with a sterile, biologically inert implant (such as silicone or Medpor) which is placed over the bone of the lower jaw so it feels like your real chin and not like a separate implant.A wide range of chin implants are available, depending on the patient’s needs and goals. These implants vary in their dimensions and are made of different materials. The proper selection of the correct size and type of implant by your plastic surgeon is critical for you to achieve the look you want.It is very important to select a highly-skilled, board-certified plastic surgeon, or ENT or Oral Surgeon experienced in this procedure, to aid you in selecting the implants and insertion methods that will give you the best possible result. #chinimplant #chinaugmentation

Barry L. Eppley, MD, DMD · Answer

The key aesthetic question is what do you want the result to look like from a frontal view. Chin implants can make your chin wider if you desire while a sliding genioplasty will make it look somewhat more narrow and that change is largely unavoidable. For the amount of chin augmentation that got likely desire (modest), a chin implant seems like the better operation for you despite your young age.

William Portuese, MD · Answer

A sliding genioplasty is performed by oral surgeon as an inpatient procedure under general anesthesia at a hospital with an overnight hospital stay. This is usually performed when patient's have significant dental occlusion problems.  A Silastic chin implant can be inserted through a small submental incision under local anesthesia as an outpatient procedure which takes approximately 30 minutes. Chin implants can also be removed if ever desired. For many examples of chin implants, please see the link below

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

Hi, I have performed many chin augmentations over the past 30 years.  From the photos, your chin is weak.  A weak chin creates an imbalance making the nose look larger and the mid face appear top heavy.  Chin augmentation, with a chin, implant will add projection to the chin creating harmony and balance to the lower face.  I have found chin implant surgery, through a small curved incision uner the chin, to be very safe, quick and highly effective. The surgery can be performed using a local anesthetic.  In comparison a sliding genioplasty is far more invasive as it requires bone cuts, metal plates and or screws.   Following the beauty principles outlined in my book on face and body beauty, men look ruggedly handsome with angularity in the cheeks, chin and mandibular angle.  In addition to chin augmentation, augmenting the mandibular angle with a dermal filler (I prefer Restylane Lyft) will add volume, angularity and flare to the jaw line.  Hope this helps.

Gerald Wittenberg, MSc, DMD (retired) · Answer

You have a 'deepened' labiomental fold/under the lower lip; as well as 'tilted out'/proclined lower incisor teeth. A chin implant will accentuate negative features whereas, in your case, a sliding genioplasty done properly, has the potential to address all features 3D. Go with the OMS recommendations for sure

Deciding between a sliding genioplasty or chin implant. Any suggestions? (photos)

Answers (5)

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