Chin Implant: Under the Chin or Through the Mouth?

Here's my rationale for advocating an external incision for chin implant surgery:

The external incision under your chin heals nearly invisibly in everyone. There is no contamination of the implant from oral bacteria whan the external approach is used, and there is a lower likelihood of traumatizing the sensory mandibular nerves when the external approach is used. Lastly, the external approach of placing a chin implant is associated with less operating time, and less downtime (swelling) in my practice.

I hope this is helpful for you.
 

Your plastic surgeon should be comfortable with perfoming chin augmentation though the mouth or beneath the chin and it is not rude to ask him which he prefers or for you to make a request. You are right it is less risky to perform the chin augmentation from beneath the chin.

I personally prefer placement through the mouth unless it is an extended chin implant that is required to square the jaw or efface marrionette lines. Complication rates are essentially the same for both.

A chin implant are a relatively simple procedure. I am not certain how many a year a physician needs to do to be "proficient." I personally find that I suggest it much more often than I perform it. Many of my patients just don't want to change their facial structure that much, regardless of the clear impact on facial balance.

I would be more interested in seeing before and after photos and making sure you like the surgeon's individual results. Don't be afraid to ask, though. It's a very reasonable question.

Best of luck

asfar as I have been able to find in the literature, the rates of infection, numbness, etc, are the same for either intraoral or under the chin approach.  I prefer the intraoral approach since the scar is hidden and have never had any significant problems with that approach.  I would address it with your surgeon and seewhat they are comfortable with.  Ultimately, it is up to you where you would like to have the scar, but in reality, the long term results shouldbe the same.  I hope this helps.

I am not sure about whether any study has shown increased nerve damage with one approach over the other but there are concerns about a higher infection rate with the intra oral approach. Injectable fillers are an option as Dr. Aldea has discussed.

This is a good and common question.  Both the intraoral and submental (incision under chin) approach can be used.  There are advantages and disadvantages to each approach and your surgeon should discuss these with you.  I inform my patients and then let them decide which is best for them.  In general, I prefer the submental approach because it is less likely to change the skin crease which is between the lower lip and the chin.  The difference in risk of infection is small, but also likely less thru the submental incision.  The scar hides very well and is usually not problematic.  Good luck.

A patient has every right to ask about the Surgeon's preferred surgical approach and the rationale for his/her decision.  The intraoral approach has a higher infection rate, implant placement is more reliable with the submental approach, and the same submental incision used in Facelift can be utilized for an implant in a concurrent procedure.  All of these factors contribute to my preference in using the submental approach.  At the same time, many Surgeons prefer the intraoral approach and obtain great results.

It is definitely not rude to ask your physician which approach he or she uses to place an implant.  There are ups and downs of each approach.  Though the mouth can never be completely sterilized, I prefer an intraorally.  This provides excellent access and no visible scar.  The blood supply to the face is copious, thus the risk of infection is remote.  In the hands of an experienced board certified surgeon, the risk of nerve damage via either approach is also very infrequent. 

I don't think it is rude ever to ask how many someone does.  It does not need to be fifty a year - but I think some idea of the confidence and experience someone has is a very reasonable question to ask.

I have performed chin implants both ways and I must say that I much prefer the approach through the submental incision under the chin.  I typically place anatomic implants because I like the more natural projection and the improvement they provide in the pre jowl area. These are longer implants and I found them easier to place from the external approach.  The scar really has not been an issue for any of my patients.  i also prefer to keep saliva away from the implant material although I cannot say that I have ever had an infection from a chin implant.

It is important to go to a facial plastic surgeon that performs many chin implants per year. A good number of implants would be 50 to 100 per year for the surgeon. The chin implant is best placed through a submental incision underneath the chin placed directly over the mandible underneath the periosteum. It is not advisable to have it done through the intraoral approach because of the migration of the implant upwards towards the teeth and chance of infection. There is much less complications with the submental approach.