Chin Augmentation-Which method is best? (photo)

I am planning to get a (conservative) chin augmentation and know that it is sometimes done from the outside of the chin and other times done from inside the mouth. What are the pluses and minuses of each approach? Is one more expensive than the other? Also-how much bruising should I expect--want to know how long to take off work. I'm from NYC: also looking for a Dr. Thanks for your help. Susan

Doctor Answers 10

Chin Augmentation-Which method is best?

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  I allow the patient to decide the approach as I do both.  The scar is not visible with the intraoral approach, but the infection rate may be higher in this approach.  

Kenneth Hughes, MD

Los Angeles, CA

Either approach is good

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I've been performing chin implants for 27 years and do both approaches (if the patient is having neck work, I place it through the submental incision, but otherwise place it intraorally).  I have never had an implant infection using in intraoral (inside the mouth approach) using numerous types of implants and when placed properly, there should not be problems with mobility.  The key, just like with everything, is that your surgeon is experienced and comfortable with whatever approach they recommend for you.  There certainly should be no cost difference dependent on the approach. 

John Frodel, MD
Atlanta Facial Plastic Surgeon

Chin Augmentation approach

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In thirty years and thousands of chin augmentations I have never done one from inside the mouth. I do not even know any other surgeons I respect who do. The indications for doing an oral approach to chin augmentation almost do not exist. The only possible advantage is the absence of a 1/2 inch very hard to see scar under the chin. I cannot think of any of my patients who ever complained or said anything about this incision afterwards. However the oral approach leaves the possibility of infection with an implant a real and serious concern. It is also harder to position the implant along the inferior border of the mandible from the oral approach. I do the whole chin augmentation procedure under local anesthesia in the office in under 20 minutes skin to skin. A simple, great, easy, and very rewarding surgery. Do the surgery on a thursday and go back to work on monday. I have lots of before and after photos on our web site with and without combined rhinoplasty work

Chin implant candidate

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In our practice we recommend chin implants be placed through a sub mental incision, not the intra-oral approach.  The intra-oral approach can get infected and the implant  tends to migrate more.  Silastic chin implants come in a variety of sizes and shapes which is best determined at the time of consultation and examination. 

Submental vs Intraoral Chin Implant Placement

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While placing a chin implant can be done from either inside the mouth (intraoral) or under the chin (submental), the most important issue is getting the desired result with the least recovery and a low risk of potential complications. This is almost always going to be from the submental approach. While the small scar to place it is often a concern to patients, it shouldn't be as it is rarely an aesthetic problem when well done. Coming from below disrupts the least amount of the muscular attachments, is more assured in getting proper implant position that is stable and will not cause any temporary interference with lip function, eating or oral hygiene, thus making recovery easier.

Chin augmentation - Denver

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The one advantage of an incision hidden behind the lip is lack of a scar under the chin. The scar under the chin actually heals very nicely in the vast majority of people. The downside of that hidden scar is a higher risk of implant infection and a higher incidence of implant migration/ malposition. Given these factors, I find that a small external incision creates the most predictable results.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Chin implant approach

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I use an external (submental) approach for my chin implant surgeries, but it can be done with an intraoral incision as well. The submental incision is very well hidden and does offer a lower incidence of implant infection complications. The recovery is a bit variable with some patients having little to no swelling or bruising and others with up to 3 weeks of swelling and discomfort. You might be able to return to work in as little as 1 week after surgery, depending upon the type of work that you do. 

Chin implant best method

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I prefer to place chin implants through an external incision under the chin. One can also place them through the mouth. I find that the external incision heals without any major issues. It also  allows access to the neck to perform liposuction if necessary, but more importantly, the approach is less disruptive than the intraoral approach in that the muscles that insert on the chin are lifted up and not cut or transected as the case when going through the mouth.  Furthermore, one has a better ability to create a precise pocket to fit the implant. I also like the ease of reversibility should that be necessary.
Arthur Falk MD

Arthur N. Falk, MD
Albany Facial Plastic Surgeon

Chin Augmentation technique

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I personally prefer a small incision under the chin. This has the lowest risk of complications such as implant malposition and infection. This can also be combined with a small amount of neck liposuction in some people. Most of my patients expect minor bruising and swelling with a rapid return to work (within a week). We can discuss this in much more detail during your consultation.

Chin Augmentation

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The 2 approaches are the submental and intraoral approach. The intraoral approach saves you an external incision but has chance for post -op complication. The submental approach involves a small submental incision in the chin crease but has less chance for infection. Overall the surgeon will choose the approach he/she is more comfortable with. There is very little bruising and 4 to 5 days of recovery for swelling.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.