23, female, weaker lower face area. Is a chin implant the right choice for me? (Photos)

Question

I (23F) am considering a chin implant to help with my weaker lower face area. However, I’m not sure if it’s my chin that’s recessed or my jaw or both. Depending on which one it is, is jaw surgery a better option for me? For context, I’ve had braces and had regular visits with an orthodontist growing up which helped improve my recession. I don’t believe I struggle with sleep apnea as I’ve always slept through the night but I have been told I sometimes make noises (apparently not snoring though) in my sleep. I also sometimes breathe through my mouth when sleeping. Based off of this and the pictures, I’m wondering if I’m a candidate for jaw surgery or if a chin implant would suffice.

Carl Truesdale, MD · Answer

A weaker lower face at 23 is structural, not age-related, so the right intervention depends on what's actually causing the appearance.
There are three common scenarios that look similar but need different treatments.
Microgenia (small chin bone) is the most common. The chin projection is genuinely short relative to the rest of the face. Chin implant or sliding genioplasty both work here. Implant is faster recovery, genioplasty is more customizable for vertical and side-to-side adjustments.
Retrognathia (the entire lower jaw is set back) looks similar but is a skeletal issue. Chin implant alone won't fully fix it because the underlying mandible is positioned posteriorly. This needs an orthognathic evaluation, which an oral and maxillofacial surgeon does.
Soft tissue insufficiency without a bony problem is the third pattern. Sometimes a lower face looks weak because the chin pad fat is thin or because of jowl-line attachment patterns, not because the bone is small. In these cases filler or fat grafting addresses it better than an implant.
The diagnostic move is a cephalometric x-ray (a side-view skull x-ray with specific measurements) which most facial plastic surgeons or orthodontists can order. It tells you in 5 minutes which category you're in.
For most 23-year-olds with isolated weak chin appearance and normal bite, a chin implant is straightforward and gives a strong result. Recovery is about 5 to 7 days for swelling and the chin shape settles by 6 weeks. The harder decision is implant material (silicone, Medpor, custom-printed) and size, which a surgeon should help you decide based on your facial proportions.
Don't make this decision based on photos of other patients alone. Your own anatomy needs to drive the plan.

Philip Wasicek, MD · Answer

I would recommend being evaluated by a board certified plastic surgeon/orthognathic surgeon. Double or triple jaw surgery needs to take into account your dental alignment and occlusion, as well as your facial skeleton. It is also a much bigger surgery to undertake. 
For patients who are unsure, and/or hesitant to commit to permanent changes with orthognathic surgery or an implant--I will frequently recommend trying filler for chin augmentation to see if this is able to get you the results you are looking for. If it is what you are looking for, some patients will eventually progress to getting a chin implant/augmentation. This may be a reasonable option for you, especially since you may benefit from a more incremental or subtle change. 
Hope this helps.

Gary M. Horndeski, MD · Answer

You may benefit from a chin implant.  This is done through an intra-oral approach so there are no external scars.  This takes 1 hour to perform under general anesthesia and costs $5,000.

Best Wishes,

Gary Horndeski, M.D.

23, female, weaker lower face area. Is a chin implant the right choice for me? (Photos)

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