Cheeks and chin implant or rhinoplasty first?

Question

Hello! I'd like to get a cheek augmentation with a chin implant and a rhinoplasty but will have to space them out because of financial reasons. How does getting my cheeks and chin done before or after a rhinoplasty affect each other in terms of facial harmony?

Anita Patel, MD, FACS · Answer

This is an excellent question. Facial harmony and beauty depends on relative proportions of the features, not each feature in isolation. In other words, changing any one feature has an effect on overall facial harmony. Often a chin implant is done at the same time as a rhinoplasty. In terms of what should be done first, this is impossible to answer without seeing you in person, or at least seeing photographs to help give general guidelines. If your budget is really tight, keep in mind you also have nonsurgical options such as cheek augmentation with filler, chin augmentation with filler, and even non-surgical rhinoplasty.

Zoran Potparic, MD · Answer

It would be best if you address the dominant problem first; if it is your nose consider rhinoplasty or rhinoplasty with chin augmentation first. Once dominant problem is resolved you will see other "deformities" more clearly and make your next decision easier. Good luck.

Michael I. Echavez, MD · Answer

It would really not make that much difference in which order you had a rhinoplasty, cheek augmentation and chin augmentation.  In my opinion, there is no clear advantage to doing one before the others.

Barry L. Eppley, MD, DMD · Answer

Without seeing pictures of you I can not say for sure. You need to prioritize these three facial needs in order of importance of change to you. Then do the most important ones first. If you are unsure how these facial zones of change may impact your appearance have computer imaging done to help you rank their order of facial importance.

William Portuese, MD · Answer

A rhinoplasty procedure is usually performed in combination with a chin implant procedure for facial balance and proportions. Chin implants and cheek implants are composed of Silastic, and are manufactured in a large variety of sizes and shapes.  Cheek implants and a rhinoplasty usually performed under general anesthesia, while a chin implant can be performed  under local anesthesia as a standalone procedure.  For more information, our current price list and many examples, please see the video and the link below

Sean Freeman, MD · Answer

BurntSugar, I would do your chin and nose together and your cheeks secondarily or primarily depending on your exam. See an experienced surgeon that does "only faces". See the video and good luck!

Patrick J. Byrne, MD, FACS · Answer

Hard to say without photos, but for most patients the benefits are additive, assuming your need for your nose is to reduce projection / dorsal hump etc. In other words, your face is likely to look better after the first procedure, and better still after the next. The exception might be if you are seeking augmentation rhinoplasty along with chin augmentation/ cheek augmentation. In that scenario, if you do the cheek / chin first, it may accentuate the nasal deficiency. I hope this makes sense! Best of luck.

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

Hi, non smiling photos of your face from the front and side would help with the evaluation. I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years as well as many Rhinoplasty surgeries. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  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.  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.

Think of facial beauty as something that "must" address all layers of the face including the skeletal structure of the cheeks and chin, the overlying SMAS muscle, amount and position of subcutaneous fat and finally the degree of skin laxity. It's an "urban myth" that pulling tissues over flat cheeks and a weak chin can create a beautiful or handsome face. Similarly, dermal fillers or facial implants alone can't lift and remove excess skin from the face and neck. Natural looking beauty is created by the aesthetic vision of what tissues layers need to be adjusted by what technique and amount. While Rhinoplasty can thin and refine the nasal shape, it by itself will not have the aesthetic impact that Cheek and Chin Augmentation have on creating facial harmony and beauty.  For that reason, you may want to have the Rhinoplasty by itself at a later date.Hope this helps.

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