Would a 9mm anatomical chin implant be too big for my face? (photos)

We almost always prefer/recommend a genioplasty over an implant. A genioplasty has many benefits over an implant, and is generally more predictable. Implants are limited, and will make your chin wider, which does not sound like something you want. From the front, the lower portion of your face is short compared to the rest. However it sounds like you prefer it that way. If you are just looking for forward advancement, I would look into getting a genioplasty before you make any final decisions. A genioplasty can advance your chin without any implants or creating a bulky appearance.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for your question and sharing your photographs.

One of the common problems with designing and planning changes for the chin is that the profile view is used almost exclusively. Many times, the concerns after surgery can be the result of the appearance from the front or oblique view.

I suggest that you should have a consultation with a surgeon that uses 3D imaging and simulation. This allows evaluation of the degree of change that you seek to achieve and measurement of the respective projection. It also allows you to try and image around and examine a variety of angles.

Medpor implants can be carved to tailor the shape to the desired outcome and have a good correlation with the preoperative planning. Custom made implants can also be used to this effect.

When a chin is very recessive and needs 9 mm of advancement I recommend a sliding genioplasty procedure. I perform both genioplasties and the placement of implants, and when a large implant is placed in a women it can sometimes look wide and masculine. The genioplasty procedure brings your own natural chin forward and looks more feminine. The procedure is performed in the office with sedation anesthesia and does not affect your bite. Most people resume a normal diet the same day.

A small anatomical chin implant would be the appropriate size for your petite facial features. Placement of a chin implant can be done under local anesthesia as an outpatient procedure which takes approximately 30 minutes. In our practice, we place the implant through a small submental incision.

Historically when I’ve done chin augmentations using implants I never preselected what size implants to use.
Instead I always had a set of sizers which is a set of temporary implants in different sizes used during surgery to determine what size implant to use.
During surgery different size temporary implants or “sizers” can be placed in the pocket and an assessment made in regards to what looks best. The surgeon will also bring a variety of different permanent implants to have available to choose the most appropriate size during surgery.
This requires that the surgeon either have an inventory of different size implants or order a variety of sizes and then send back the ones that weren’t used.
Different providers have different ways of doing things. I found working with sizers and having multiple size implants available during surgery to be the most accurate in terms of getting the desired look.
For almost all cosmetic surgical procedures there is inherent differences in school and experience among different providers.
People simply have different skills and different providers do things differently.
Because of this and the impact of having a permanent change to your face I suggest patient be very selective when it comes to choosing the right provider.
Defined the best provider requires vetting plastic surgeons and having multiple in person consultations.
Pre-selecting one surgeon having a consultation and then letting that surgeon do your procedure completely eliminates the ability of finding someone better.
Personally I recommend patients start the process by having at least five in person consultations.
During each consultation ask each provider to open their portfolio and show you their entire collection of before and after pictures.
Bring pictures of your own face to use as a reference.
As providers to only show you before and after pictures of previous patients who have similar facial characteristics to your own.
This includes the same labiomental angle and similar facial skeletal imbalance.
As providers to show you a variety of outcomes. Ask them to specifically show you results that are excellent, average and results that did not turn out as well as they had hoped.
An experienced surgeon should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures.
Being shown a handful of preselected images representing the best work of a providers career is insufficient to get a clear understanding of what average results look like or how many of these procedures they’ve actually done.
I sufficiently experienced and confidence provider should not be intimidated by being asked to show you a variety of outcomes.
Providers are only show you their “show and tell” or “sales” photo album are not giving you access to what results look like that are anything but their best outcomes.
In reality the majority of patient do not get textbook perfect outcomes. The majority of patients good average results, sun will get less than average and some will get great.
In reality the majority of patient do not get textbook perfect outcomes. The majority of patients good average results, sun will get less than average and some will get great outcomes.
The goal in reviewing before and after pictures is to get an understanding of what average results look like, understand what results can look like based on your individual candidacy for the procedure and the vet the provider in regards to experience.
Providers may be apprehensive to show you anything but your pre-selected photos.
We all have a variety of outcomes and patience are in there full right to ask to see them.
Take careful notes during consultations especially while reviewing before and after pictures.
Review and enough results to have a good idea of what a quality report looks like and be able to recognize other individuals who have similar facial characteristics to your own in the before pictures.
In the end candidacy and surgeon skill are generally the only two variables that really matter.
Implants look very different when placed under the soft tissues on the bone than they do when placed on top of the skin.
Perhaps your surgeon as humility to preselect implants and get consistent quality outcomes. For myself I always felt more comfortable having a full selection of implants available during surgery and using sizers.
I also think that anybody considering this procedure should investigate the alternative procedure which is a sliding genioplasty.
Both procedures have advantages and disadvantages. A sliding genioplasty can be performed by some plastic surgeons what is more commonly performed by oral surgeons.
Oral surgeons by their inherent training tend to be more bone oriental while plastic surgeons tend to see things more from a soft tissue perspective.
It’s not a bad idea to consult with both oral surgeons and plastic surgeons to get a quality assessment and better understanding of the facial dynamics especially when it comes to understanding deficiencies in the mandible.
Excessive forward projection with chin augmentation will lead to an undesirably sharp labiomental angle. 9 mm may be appropriate but personally I would not pre-commit but rather make the decision during surgery.
When in doubt slow down and schedule more consultations.
Best,
Mats Hagstrom MD