Posted on October 7, 2011 in Chin Implant, Facial Plastic Surgery
This young female patient from San Diego is a great example of how a chin implant can significantly enhance facial harmony and balance without looking surgically ‘altered’ or ‘done’ as some people fear. This particular patient had what we would describe as facial plastic surgeons was poor chin projection. Meaning, her chin simply too small for her lower face and did not project outward sufficiently to be in balance with the mid to upper face. In most cases, we evaluate chin projection and position by looking at the side view, or profile.This is shown in the adjacent photo diagram of this patient taken prior to chin implant surgery. An imaginary vertical line is typically drawn straight down from where the red and white lip meet. Ideally, the chin in a female patient should project forward to within millimeters of this line on average. As you can see, the most prominent point of her chin, as seen from the side view, sits several millimeters behind what is considered ideal.
Chin Implant For Facial Enhancement
In this case, the patient opted for augmentation of her chin using a chin implant, which is clearly the most common method of chin enhancement in my practice. By going from underneath her chin, I was able to hide the scar quite nicely. In addition, this approach allowed for more accurate placement of the chin implant and less likelihood of her getting an infection (compared with placement done through the mouth). Overall, you can see from her before and after photos that her lower face is now in much better balance and harmony with the mid and upper face regions. Her chin contour has been notably enhanced and she has improved definition of her jawline. Arguably most important is the fact her jaw and chin still look very natural for her facial features. Although we know she has a chin implant, this is not something that is readily picked up by someone walking by her on the streets of San Diego.
Chin Implant Consultation in San Diego
If you have an underdeveloped chin and/or desire enhancement of your chin projection, feel free to contact our San Diego office today for a complimentary consultation for chin implant surgery.
Posted on October 4, 2011 in Chin Implant, Neck Lift, Neck Liposuction, Plastic Surgery, Platysmaplasty
This is a great case example of how to perform a neck lift on a patient using a combined surgical approach. This particular male patient from San Diego, CA desired a more defined neck line. On examination he was found to have evidence of excess fat under the chin as well as a poorly shaped muscle, called the platysma muscle. Furthermore, he had less chin prominence than average. We discussed the various options available to him to provide a cosmetic enhancement of his neckline. Ultimately, he decided on a combined approach, which is what was performed on him. This included neck liposuction (also called cervical liposuction), tightening of the platysma muscle (called platysmaplasty) and placement of a chin implant to augment the jawline (also referred to as a mentoplasty). Following surgery, he was noted to have a significant enhancement in his neck and jaw region, which is precisely what he desired going into the procedure. To see his dramatic improvement from this combined necklift surgery, use this link here.
Posted on February 16, 2011 in Chin Implant, Plastic Surgery
I wanted to quickly discuss the topic of chin enhancement or chin reshaping using a chin implant for augmentation. Many potential chin implant patients inquire about sizing of the actual chin implant. They often ask, “How do you know what size implant I need to enhance my chin and jawline?” The answer is – I measure it!
My ‘Old’ Approach To Chin Implant Placement
When I went through my facial plastic surgery training, I was taught that you should use what are called ‘implant sizers’ when performing chin enhancement surgery. Basically, you have a general idea of what size chin implant you want to use to get the desired chin shape and size. Once in surgery, you then place a chin implant sizer into the area where the real implant will ultimately sit. The chin implant sizers are replicas of the real implant but come in a range of sizes and shapes. The sizers are intended to guide your plastic surgeon with the proper choice of chin implant. With the implant sizer in place, you make a visual assessment of the patient’s chin to see if you need to go up or down in size with regard to the implant. Once you decide on the appropriate size, you remove the implant sizer and place the real chin implant and complete the surgery.
The Problem With Chin Implant Sizers
Unfortunately, when using a chin implant sizer to determine the appropriate choice of implant for chin augmentation, there is one considerable hurdle – swelling that occurs during the surgery. Despite very careful surgical technique and gentle handling of the tissue, some chin implant patients will develop swelling of the area as the operation is ongoing. In these patients, there can be considerable inaccuracies when measuring whether or not the chin implant sizer is the correct choice for reshaping the jaw. After all we dealing with changes to the shape and size of the chin that are on the order of millimeters. So even moderate swelling during the chin augmentation surgery can lead to the wrong choice of implant for that particular patient.
My ‘New’ Approach To Chin Implant Placement
Because of this very issue, years ago I decided to take a new approach to chin enhancement surgery with an implant. I simply began measuring my San Diego chin implant patient’s deficiency in terms of chin projection before we actually went to surgery. During either the initial chin implant consultation or preoperative visit, I photograph my patient holding a ruler as shown here. By drawing a vertically line down from where their current chin ends, I can determine more accurately how many millimeters are needed to augment the chin. And this measurement is being done without confounding factors such as surgical swelling that are present with the old approach. Based on this actual measurement, I can choose a chin implant with the shape and size that is just right for my patient. Looking back over time, I feel quite strongly that this new approach to chin implant surgery to enhance the jawline and lower face has resulted in much improved esthetic outcomes for all of my San Diego chin implant patients.
Posted on February 14, 2011 in Chin Implant, Facial Plastic Surgery, Neck Lift, Neck Liposuction
Virtual plastic surgery consultations are becoming increasingly popular as the world becomings smaller and smaller thanks to the world wide web. For those plastic surgery patients outside of San Diego, we have been offering Skype consultations online. This includes several plastic surgery patients that live in outside countries. Many of these cosmetic surgery candidates discovered our San Diego plastic surgery practice while doing online research for their desired facial enhancement procedure. This includes patients seeking out rhinoplasty (nose reshaping), revision rhinoplasty (nose surgery following prior nasal reshaping), facelift (face lift), necklift, chin implant (chin reshaping), ear reshaping (otoplasty) and more. For instance, I just had a Skype consultation with a very nice lady who lives in Dubai. She heard of our plastic surgery practice through a previous facelift patient of mine who had come out from Dubai to have her surgery performed by me. Since there are considerable logistics that need go into planning a plastic surgery procedure from afar, we offer the Skype plastic surgery consultation as a nice preliminary option to meet each other. Although I am not able to physically examine the patient, I am able to gain a nice perspective of what their face and neck region look like. I can also have the patient rotate on camera, giving me an appreciation of their 3-dimensional appearance – a significant advantage over just photos. There is certainly no substitute for an in-person consultation when it comes to deciding on plastic surgery. However, a Skype cosmetic surgery consultation is a great way to determine one’s overall candidacy for various plastic surgery procedures.
Posted on January 24, 2011 in Chin Implant
I see this topic as a point of discussion on many plastic and cosmetic surgery forums. The reality is that almost everyone who gets a chin implant has some degree of bone resorption following the surgery. But this fact should not be something that is a great source of anxiety over having a chin implant procedure. The bone resorption that most cosmetic chin augmentation patients get following the implant placement is fairly minor. In fact, most patients, once healed, don’t even really notice there has been any resorption. So, although there is some resorption of bone after chin reshaping with an implant, almost everyone gets it and this typically does not detract from the cosmetic chin enhancement results.
Posted on January 17, 2011 in Chin Implant, Neck Liposuction
I have seen this question or a variation of this online. The answer is it really depends on what your anatomy is like. To help clarify this question about chin implant versus neck liposuction/neck reshaping, I posted a blog entry with case description a little while ago. Here is the link for your review: Case example of chin implant and neck liposuction with platysmaplasty.
Posted on November 16, 2010 in Chin Implant, Neck Lift
We have had several patients consulting with us over the past few months for chin augmentation with placement of an implant. Many of these patients were seeking an increase in projection to achieve more definition along the jawline and upper neck. In several of these patients, it was noted that tightening of the platysma muscle would also prove beneficial in their surgical outcome so I decided to post a quick blog regarding this combination procedure. The following case example highlights some of the more pertinent points. This patient from San Diego desired improved definition of the jawline with a stronger looking chin. We consulted with him and decided that a chin implant would help him achieve this type of change. However, during consultation I also pointed that his neck was poorly defined and might benefit from additional work beyond just a chin implant. We decided that his neck could also be contoured by tightening the muscle just underneath the chin, called the platysma muscle. The procedure, termed a platysmaplasty, would help provide him a longer horizontal neck line, which would also further improve definition of his jaw. The photo on the left below shows his profile view before any surgery. The next photo over shows his actual postoperative result following combined chin implant and platysmaplasty. As you can see in the diagrammed photo below, the chin implant was able to provide further definition as indicated by everything in front of the red curved line (his original chin contour traced out). Had we just performed the chin implant, this would have been the only improvement realized. The platysmaplasty portion of the procedure was able to eradicate the excess fullness under the chin as indicated by everything shadowed behind the blue outline. Had we only performed the platysmaplasty, this is the only improvement that would have been seen. Using the diagram for comparison, one can easily appreciate how combining the procedures can dramatically increase the results. If you are considering chin augmentation with a chin implant and think you might benefit from this type of combined procedure, give our office a call to schedule a complimentary consultation. We look forward to meeting you in person. Sincerely, Dr. Hilinski
Posted on November 1, 2009 in Chin Implant, Rhinoplasty
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!).
Posted on September 28, 2009 in Chin Implant
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.
