Chin implant or sliding genioplasty? (photos)

Question

Not happy with my lower face. I would like to elongate my face to soften it up. I have a slightly crooked chin. What would work better-implant or genioplasty? Would my cheek volume change after genioplasty? Would either procedure fix the crooked chin? Do you think this is a good route for enhancing my facial harmony? I've had surgeons suggest rhinoplasty, jaw surgery, buccal fal removal...I don't know who to listen to at this point. Suggestions welcome!

William Portuese, MD · Answer

A sliding genioplasty is performed by an oral surgeon under general anesthesia in a hospital is setting with an overnight hospital stay. A chin implant is performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. The pre-existing asymmetries can be adjusted by shaving down the implant itself on the higher side. For more  information and many examples of chin implants, please see the link and the video below

Richard Chaffoo, MD, FACS, FICS · Answer

Hi and thanks for your question. Without an exam it is not possible to give you accurate advice so see a local board certified plastic surgeon. Good luck.Richard Chaffoo, MD, FACS, FICSTriple Board Certified Plastic Surgeon

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and at a consultation aided by digital photography you would literally be able to see how you might look with surgery.  So see some experts in your area that use this technique and be evaluated.Dr. Corbin

Dennis Barek, MD (retired) · Answer

Chin augmentation with an extended anatomic implant should make a significant improvement in your chin. The asymmetry will be less and, if needed, there are ways to add more augmentation to the more depressed left side.

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

Hi, I have performed many facial shaping procedures for over 30 years using dermal fillers, facial implants (cheek, chin) and facelift procedures as needed.  I
tell potential facial shaping patients to think of creating a more beautiful or
handsome face by working on three tissue levels.  The bony structure
should be appropriate to make a woman’s face heart shaped and a man’s face
chiseled and angular which is described below.  Next the fatty layer
should be reduced or shaped allowing the shape to be seen and finally excess
SMAS and skin evidenced by the presence of jowls) should be removed from the
face and neck.  From the attached photos, the cheeks
are flat anteriorly (in the front), the chin is weak, there is excess facial and neck fat along
with excess facial skin evidenced by jowls and nasolabial folds.  These
combine to create an elongated to rectangular shaped face which is a relatively masculine shape.   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 using a dermal filler
(I prefer Restylane Lyft) or with cheek implants for a permanent enhancement
will create full, round cheeks anteriorly that will feminize the entire face.   When the chin is weak, this creates an imbalance making the nose appear
larger, the mid face top heavy and the lower face appear shorter which
de-emphasizes the shape and fullness of the lips.  Chin augmentation,
using a chin implant, will add projection to the chin creating harmony and
balance to the lower face.  I have found placing a silastic chin implant through
a small, curved, incisions under the chin to be very safe, quick, highly
effective and far less invasive than a sliding genioplasty that requires bone
cuts with placement of screws and metal plates.  Jowls are sagging facial
tissues and an indication for some form of a SMAS facelift.  The
underlying SMAS layer, of the face, must be dissected, lifted, trimmed and
re-sutured.  The excess skin is then removed and the facelift incisions closed.  My most popular facelift is the
minimally invasive, short incision facelift that has all the benefits of more
invasive facelifts (traditional, mid-face, deep plane and subperiosteal
facelifts) but with these added benefits:

•very small incisions

•minimal tissue dissection = less
bruising and swelling = rapid recovery

•can be performed in 90 minutes or
less, with or without anesthesia

•no incisions within the hair = no
hair loss

•excess fat can be removed

•excess skin removed

•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-opHope this helps.

Michael Elam, MD (retired) · Answer

Dear Monica1971, If you do not have issues regarding your bite then I would not suggest genioplasty this is a much more complex procedure then chin augmentation. An in office consultation aided with digital imaging would help determine your candidacy for procedures that would provide you with nicely balanced facial aesthetics. In my personal opinion based on your photographs I would suggest rhinoplasty, and buccal fat pad removal. I have enclosed a video above and link below for you to see patients with rhinoplasty, buccal fat pad removal and chin augmentation to give you an idea of how a combination of these procedures provide a well balanced profile and overall facial aesthetics. Best regards, Michael V. Elam, M.D.

Gerald Wittenberg, MSc, DMD (retired) · Answer

A sliding  genioplasty accomplishes the symmetrical improvement and the change in height and projection. I do not know your 'bite/occlusion' so if you wish to change the bite, you may require added procedures and orthodontics. But the lower facial balance can be managed with genioplasty and augmentation approaches.

Chin implant or sliding genioplasty? (photos)

Answers (7)

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