Benefits of Chin Aug Intraorally Vs. Extraorally?

  I think honest and good surgeons may give different answers to this question, and it depends on the surgeon's preference.  I have no evidence here but I do think an external approach may be "intuitively" safer as you are not placing ghe implant through a "dirty" place such as the mouth.

Many surgeons have their preference.  There is some risk of disrupting the mentalis muscle with an intraoral approach, whereas the submental approach has an very well placed scar.Raffy Karamanoukian, Los Angeles

In my opinion the external approach allows for accurate placement and fixation of the chin implant. Lower rate of infection and no distortion of the mentalis muscle are an added bonus. The very small scar in the submental area is not visible and heals extremely well. I have attached a link to a helpful educational video.

   In our practice we have always placed  chin implants  through a small incision in the sub-mentum  known as the external approach. The implant stands a less chance of infection and extrusion and migration  when placed  through  sub-mental,  external approach.

Dear Fox,

Thank you for your post.  Benefit of going extra-orally, is that it is a quicker, easier surgery, and a slightly less risk of infection.  The benefit of going intra-orally, is that there is no visible scar.  I would prefer that if I were you. 

Best Wishes,

Pablo Prichard, MD

Whether the placement of a chin implant is done through the mouth or through an incision under the chin may be determined by what other procedures are being done.  For example, if I am placing a chin implant as a stand-alone procedure, especially for a younger person, I prefer to go through the mouth and avoid an external scar.  If I am placing a chin implant during a facelift, I am more likely to go through the skin under the chin (submental incision), as I may be placing an incision there anyway to tighten the platysma muscle in the neck.  I don't think there is any significant difference with regard to risks, swelling, bruising, or downtime.  

The benefit of the intraoral approach is the lack of an external incision. The downside is that there is a slightly higher risk of infection as well as malposition of the implant. It also takes slightly longer as the exposure is not as good. The benefits of the external approach are ease of positioning, lower risk of infection and lower likelihood of the implant moving after placement. The downside is a small incision in the crease behind the chin that typically heals very nicely. There is typically swelling for several weeks but most patients can return to work/ school/ social activities by one week. I hope this information is helpful. Stephen Weber MD, FACS

 I have placed quite a few chin implants over the past 25 years and in my opinion only the external approach should be used.  A small incision under the chin is placed and the implant is placed under the covering of the bone.  This avoids cutting the menatlis muscle attachment which must be done when using the intra-oral approach.  Cutting the muscle attachment can allow ptosis of that muscle as well as riding up of the chin implant into the mental sulcus.