For additional details, see platysmaplasty. The degree of chin insufficiency
may be judged only from the lateral view. If a perpendicular line is dropped
from the lower lip it should fall upon the point of the chin. The degree
to which this is not so dictates the amount of chin augmentation desired.
If the lower jaw is set back so far that malocclusion of the teeth is present
then assessment by a Maxillofacial Surgeon is advisable. In those cases
where a functional malocclusion is present, it may be desirable to advance
the jaw subsequent to Orthodontic treatment to effect total restoration.
This process usually requires years and is quite expensive, but in many
cases more desirable than simple chin augmentation alone.
In those cases where malocclusion is absent or
minimally present, cosmetic improvement can be obtained by insertion of
an acrylic or silastic chin implant. The implants vary in size from quite
small to very large and are variable in shape to accommodate deficiencies
of the lateral aspects of the jaw. They may be inserted either from an
incision inside the mouth or an incision externally under the chin. Where
platysmaplasty is accomplished concomitantly, the external approach is
desirable.
Details of the operation are similar to platysmaplasty
with the exception that at the onset of operation, the incision is retracted
upward and a dissection is carried down to the jaw bone and then a pocket
is created under the muscle and carried out laterally a variable extent,
depending upon the degree to which lateral augmentation is desired. The
implant is inserted and fixed in place and covered with the muscle. If
platysmaplasty is to be performed it undertaken at this point.
Aftercare for chin augmentation is similar to
platysmaplasty. Complications include bleeding, infection, nerve injury,
shifting of the implant, and rarely erosion of the underlying bone. By
and large, the operation is very safe with rare complications and enjoys
great patient satisfaction. Pre and post operative photos are shown illustrating
chin augmentation with (Patient I, Figure 1 and 2) and without (Patient
II, Figure 1 and 2) concomitant platysmaplasty.
