The answer to this question is – quite commonly. I would say that nearly 20% of our patients seeking primary rhinoplasty (1st time rhinoplasty) also consider chin augmentation with an implant. One of the main goals of rhinoplasty is to achieve improved harmony with the rest of the face. In cases where the nose is disproportionately large compared to the rest of the face, the aim would be to make it smaller. Most of these cases involve noses that are projected too far out from the face and/or have an excessively high bridge. This usually is more pronounced when looking at the profile view (side view). Unfortunately, there is a limit to how much smaller the nose can be made, particularly if one has thicker than average skin. In cases like this where even more balance is necessary, one must consider the shape and size of the chin to help compensate. These patients have a chin that is quite weak or underdeveloped, which makes a large nose appear even larger (since the lower one-third of the face looks comparatively too small). By augmenting the chin and jawline with an implant, the lower face is brought into better balance with the remainder of the face. When doing this in combination with rhinoplasty to make the nose smaller, the results can be rather dramatic. In fact, in many cases this is often a multiplicative effect and not just additive (like 1+1=3!).
A common question asked during consultation for chin augmentation with a chin implant relates to chances of the implant moving after placement. As I tell all my chin implant patients, there is always a chance the implant can shift or move slightly after placement. It is, however, very unlikely the implant will move to a significant or visible degree once placed properly.
I normally place my implants from under the chin since we are often doing liposuction or platysma muscle tightening at the same time. But even in those cases of isolated chin implant placement, I still prefer this approach. By virtue of going under the chin I can create a very short and direct path to where the implant will ultimately rest. In addition, I avoid the risk and concern of infectious complications that come about when implants are placed through the mouth (intraoral route). Once I expose the lower border of the jaw bone, I create precise pockets or tunnels under the periosteum, which is a thick, dense covering immediately over the bone. Chin implants typically have tapered tails that extend from the middle on each side that allow natural blending with your native jaw bone. These tails are tucked under the periosteum almost like your arm fits into a sleeve. In doing so, the chin implant becomes quite stable in terms of position and is inhibited from moving left or right and up or down. At this point in the operation, it is actually quite difficult to remove the implant even with surgical instruments. I also happen to fixate the implant with a single absorbable suture placed just under the jaw bone. This provides added stability until the implant area is fully healed.
Using this technique I have been highly successful in placing chin implants for augmentation of the jawline.
