Chin Augmentation

Chin augmentation surgery (mentoplasty) is indicated in order to increase the projection of the chin, usually through the inclusion of an implant.

The chin (chin) and nose make up the profile of the face. Thus, a careful evaluation of the isolated part and the whole is always important. The impression of a big nose can be a consequence of a small chin. Surgical treatment of a small or retracted chin ( chin augmentation surgery, chin plastic surgery, correction of hypomentonism, chinoplasty) involves bone advancement of the chin region or the inclusion of an implant, rigid silicone or other materials.

Mentonian implants are composed of alloplastic, biocompatible materials. They rarely cause reactions, have no toxic effects and do not lose their volume and shape over time. The body responds to these materials by forming a fibrous capsule around the implant, insulating it. The most important feature of the implant that determines the nature of its encapsulation is its surface type. Smooth implants promote the formation of smooth-walled capsules, whereas porous implants allow varying degrees of soft tissue ingrowth that result in a less dense and less defined capsule. Thus, porous implants have greater fibrous incorporation rather than encapsulation and have a lower tendency to erode the underlying bone surface or migrate due to mechanical soft tissue forces.

	solid silicone implant	Porous polyethylene implant
Benefits	Easily sterilizable, can be carved with scissors or scalpel, can be stabilized with screws or suture, does not produce reactions, is easily removable.	Less tendency to migrate, less tendency to cause underlying bone resorption, can be stabilized with screws, produces a thinner and less visible capsule.
Disadvantages	Tendency to cause underlying bone resorption, potential to migrate if not attached, likelihood of fibrous capsule being visible under thinner tissue.	More difficult placement of the implant in the created pocket, need to create a larger pocket, it is difficult to remove.

Plastic surgery for chin augmentation can be associated with other procedures, such as: plastic surgery of the nose (rhinoplasty), plastic surgery for facial rejuvenation (rhytidectomy or facelift) and facial liposuction (“double chin” liposuction). When the need for chin augmentation is discreet, this surgery can be replaced by fillers with fat or hyaluronic acid.

Surgical technique

Marking of the chin area to be augmented.
Antisepsis + anesthesia.
Incision: inside the mouth (intraoral) or under the chin (submental). The most used is inside the mouth, in the inferior gingivolabial sulcus.
Detachment of the area in front of the jaw bone.
Review of bleeding areas.
Inclusion + implant fixation or chin bone advancement + bone fixation with plate and screws.
Closure of the surgical wound + dressing with micropore.

Postoperative Guidelines

The micropore dressing over the chin should not be removed for 5 to 7 days. Rest should be done in the first few days in a bed with an elevated headboard or in chairs with a reclining back. When brushing your teeth, it will be important to use a soft bristle brush and avoid sudden movements for 30 days. During this period it is also not recommended to talk a lot or eat hard foods. Activities can be resumed after 2 to 5 days. Purples and bumps will only be more pronounced in the first few days. The pain is mild and lasts for a few days.

Mentoplasty guidelines

You will leave the surgery with a local dressing to keep the implant immobilized and protected, which will need to be kept for 5 to 7 days. Pain and discomfort are temporary and will subside easily with prescribed medication.
Avoid driving in the first 3 days after surgery.
After discharge, it will be important to rest in bed or in a reclining chair. When lying down, keep the headboard elevated 30º for 5 days. Sleep without pressing the operated area against the bed.
The day after discharge, you can take a shower. Avoid wetting the dressing for the first 5 days.
Operative wounds inside the mouth should be cleaned with the prescribed mouthwash, while surgical wounds on the skin should be washed with the prescribed soap.
Brush your teeth with a soft bristle brush and avoid sudden movements for 30 days.
From the 1st postoperative day, there will be no need for bed rest. Return to your normal activities, respecting the aforementioned limits.
It is likely that bruises (ecchymosis) and swelling (edema) will appear in the operated areas, which will disappear over time. For edema control, we recommend not talking too much and not eating hard foods for the first few weeks. A small amount of bleeding may occur in the first 48 hours. Copious bleeding or sudden volumetric variations associated with pain should be reported to your doctor immediately.
After 1 week, the protective dressing will be removed. Before that, it will not be allowed to change the dressing. All dressing changes must be carried out by your doctor or guided by him.
Lymphatic drainage sessions may be recommended.
Sun exposure should be avoided for the first 30 days after surgery. The use of sunscreen is advisable.
More intense physical activities should only be resumed 3 months after surgery (examples: swimming, running, weight training, ball sports).
You should return to the doctor’s office regularly, as requested, to evaluate the progress of the surgery and remove the stitches (if necessary).
If there are surgical wounds on the skin, after removing the stitches, start massaging the scars with the prescribed oil. In some cases, special care for the scars will be necessary.
Makeup can be used after the first week.
The outcome of your surgery will depend a lot on following these guidelines correctly. Any questions, contact your doctor.

COMMON QUESTIONS

What is the indication for chin augmentation surgery?

Chin augmentation plastic surgery (mentoplasty) is indicated for men and women who wish to increase the projection of the chin through the inclusion of implant or bone advancement. Other associated mandibular alterations will require more complex surgeries (craniofacial surgeries).

What is the recommended age?

Generally, the recommended age is 17 years and older.

What type of anesthesia is used in chin augmentation surgery?

Local anesthesia associated with sedation is the most used, but the surgery can also be performed under general anesthesia.

How long is the surgery?

Chin augmentation surgery (mentoplasty) lasts about 1 to 2 hours.

What is the length of stay?

Hospitalization time is 6 to 8 hours. Usually, the patient is released on the same day.

When will stitches be withdrawn?

Stitches will only need to be removed when the incision is under the chin, 5 to 7 days after surgery. In the intraoral incision, the thread is absorbable.

Does chin augmentation surgery have risks?

Postoperative complications are rare. Among them we can mention: hematoma, infection, opening of the surgical wound (suture dehiscence), implant extrusion, scar alterations, etc.

How long does it take to get the expected result?

The final appearance of the facial profile occurs at 12 to 18 months. The scar either leaves no marks (inside the mouth) or becomes almost imperceptible (under the chin). In the long term, all alloplastic silicone implants cause local bone resorption, unlike porous polyethylene implants.