Chin Implant Vs Sliding Genioplasty? (Photos)

Question

Which one is best for my profile? I'm really weary about having foreign substances in my face so I'm leading towards genioplasty. Also am I a good candidate for a mid face lift, so that I can get my cheeks lifted, and lip lift?

Randal Haworth, MD, FACS · Answer

There are a variety of techniques that can be used to improve your profile. A more temporary approach includes dermal fillers (e.g., Sculptra, Voluma, and Radiesse), while fat grafting, use of permanent fillers (Aquamid, Bellafill ) and facial implants would offer a more permanent solution. A sliding genioplasty is a procedure that I feel gives a rather blocky, unrefined look in a number of cases. However, in severe cases, this may be the best option. One also has to evaluate your actual bite through orthgnathic analysis and possible orthodontia.An upper lip lift will give you an alluring, model-type look as you see in the glossy fashion magazines.
And upper lip does three things:
1. Shortens the distance of the base of the nose to the upper lip Vermilion.
2. Allows your upper teeth to be seen, which is aesthetically beneficial in most cases.
3. Everts the upper lip Vermilion (rolls it outwards) to a very minor degree. I tell my patients that if they are coming to me for an upper lip lift and expect a a good deal of added "real estate" to their upper lip, they will be disappointed. 
To get a complete assessment, a board certified plastic surgeon needs to see you in for an in person consultation and to assess your upper lip against the backdrop of your upper teeth when your mouth is slightly parted.

P. Daniel Ward, MD · Answer

Dear girlmeetsnose,The question of genioplasty versus chin implant can be a difficult one to answer. A genioplasty involves moving the anterior portion of the chin forward to increase projection. In cases of severe chin asymmetry, this is a powerful and valuable procedure. It is more invasive than a chin implant and involves placement of a metal plate that holds the bone in a more forward position. A chin implant involves a small incision under the chin and placement of an implant. This is much less invasive and does not change the native facial structures. In my practice, I perform both, but over the past few years have gone to using a chin implant almost exclusively, because it is less invasive, does not involve any sort of permanent bone cutting, and it can be easily reversed if you don't like it.For your cheeks, you do not appear to have jowls to me. You may potentially benefit from some contouring of the face with cheek filler and Botox to the masseter muscles to help thin the face, but I do not think that you need a face lift.Regarding your lips, I think your lips look great and do not think that a lip lift is indicated, based on the photos.Please let us know if you have any other questions!

Barry L. Eppley, MD, DMD · Answer

While your chin weakness is mild and an implant would normally be appropriate for this type of chin augmentation, an aversion to an implant material leaves only the sliding genioplasty as a treatment option. A midface lift is not an effective cheek augmentation strategy, fat injections is your case need to be considered. A lip lift would shorten the distance between your nose and upper lip.

William Portuese, MD · Answer

Chin implants are placed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. A sliding genioplasty is performed under general anesthesia by an oral surgeon in a hospital setting with an overnight stay. It is much more invasive is usually performed not only augment the chin forward, but to make the teeth fit together properly. Consider placement of a small chin implant for cosmetic purposes.  For many  before and after examples, please see the link and video below

Val Lambros, MD, FACS (retired) · Answer

what is your ethnic background? If you are a person of color I would strongly not recommend a lip lift. Your cheeks look fine to me and could be managed with some filler. I think a chin implant would be simpler and fixes  exactly what you want fixed, which is a slightly recessive chin. People who say they are afraid of foreign bodies seem to not be afraid of their fillings.

Gerald Wittenberg, MSc, DMD (retired) · Answer

a genioplasty will maintain a more feminine look from the frontal view in your situation and is a natural continuation of your jawline. Balancing out the upper lip and midface, it is a good suggestion to investigate

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

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants for the cheeks, chin and lips, liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front, the chin is very weak and the back portion of the jaw line is also a bit weak.  However, there are no signs of "jowls" in the lower face or "nasolabial" folds in the mid face.  These factors combine to create an elongated, oval shaped face.  
 Following my beauty principles, 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.
 I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  A weak chin 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. 
 Silastic facial implants are the best tolerated implants in the body but that doesn't matter if you have an aversion to something foreign in your face or body.  The sliding genioplasty however also uses foreign substances in the way of metals screws and plates necessary to secure the bone cut segments.  In addition, I question whether your small chin bone cap is sufficient to provide the necessary degree of forward projection to correct the weak chin.  This would not be an issues using a silastic chin implant.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).
  I have performed many facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts. The lack of "jowls" and "nasolabial" folds would indicate you are "not" a candidate for any form of facelift procedure.
 "Jowls” are sagging facial tissues and the primary indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Chin Implant Vs Sliding Genioplasty? (Photos)

Answers (7)

More Chin Implant Questions

WE SEND PRETTY
EMAILS

Answers (7)

More Chin Implant Questions

Can I massage to move the chin implant down (4 weeks post op)?

What type of CT scan used to see a 3D imaging of the mandible and chin implant?

How hard is a silicone chin implant? Can you bend it to fit the chin anatomy?

Is bone absorption due to chin implant reversible?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS