Chin implant: under or above the periosteum?

Question

Referring to silastic implants, I read that placing it under the periosteum will help secure the implant in place without a screw. However, when placed above the periosteum, it prevents future bony reabsorption. What are the pros and cons of each and which technique do you prefer? Thanks!

Catherine Winslow, MD · Answer

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!

Zoran Potparic, MD · Answer

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.

Bahman Guyuron, MD · Answer

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.

David R. Alfonso, MD, FACS · Answer

I typically place the silastic implant under the periosteum for optimal coverage and positioning the resorption of bone is minimal and not typically significant enough to notice

Barry L. Eppley, MD, DMD · Answer

None of those contentions about chin implants are accurate. The location of the chin implant placement, above or below the persiosteum, does not affect implant stability or the potential for implant settling into the bone a bit.

Chin implant: under or above the periosteum?

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Chin implant: under or above the periosteum?

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Everything you need to know about Chin Implant

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