Chin implant: under or above the periosteum?

Hello! I prefer Goretex implants which bypasses many of the issue of silicone such as movement and late infection and malposition. I prefer a contoured, extended implant for a more natural look to the chin. I personally place the lateral flanges under the periosteum and the central portion over the periosteum. Each surgeon will have a personal preference on what works for them. I recommend a consultation with a couple different surgeons experienced with chin augmentation. Good luck!

It doesn't seem to make much of a difference whether implant is on top or underneath periosteum. Most of surgeons would place it underneath because of tighter pocket and safer dissection. Whether it creates difference in long term bone erosion is still a question. Loss of bone underneath the implant may be visible on x-ray after many years; however, it is very hard to observe any changes in the size and shape of chin in most cases. Sliding genioplasty is another option for chin augmentation. Good luck.

Bone erosion is largely related to the type of implants that is used. Porous implants are less likely to erode, specially if they are placed on the dense bone. Silicone implants are more likely to erode. The problem with placing the implant above the periosteum is that it increases the change for dimpling in chin on animation. The best procedure for chin surgery is sliding osteotomy which is more anatomical, less foreign material and is more versatile.