About Face

Procedures Menu

About Face

Chapter Seven The Lips The Shape What Can Be Done Chin Surgery Lip Surgery The Paris Lip

Chin Surgery

Analysis of the chin with a normal bite can reveal a chin that is not prominent enough. Further study will tell whether the defect is anterior-posterior prominence from the side view or not enough width (from the front view). Most facial cosmetic surgeons use a wraparound solid silicone implant to correct this. It was designed by my friend, Dr. Harry Mittleman. I use the Mittleman pre-jowl chin implant to create chin projection and chin width, keeping the lower chin area in balance with the rest of the face. They come in different sizes, but can be nicely tailored to individual situations. I make a one-and-a-half centimeter incision under the chin (where twenty percent of people already have a scar through previous trauma, usually a childhood fall). I then elevate the fleshy soft tissue off the bone, creating a picket for the implant and suturing it in. Infection. mobility, movement, and asymmetry are very rare complications and the patient has a balanced lower third of the face after two weeks.

Analysis of the lower third of the face can also reveal that a patient’s chin is much too large in its context. For patients with a normal bite, I can reduce the size of the chin. An incision is make inside and behind the lower lip (below the teeth) to loosen the lip and skin so that we can peel them away to expose the bone underneath. Then we use a surgical vibrating saw to pare down the bone. It’s the same sort of saw that a neurosurgeon uses to bore holes in the skull: the saw reacts only to bone, so there is not danger of cutting soft tissue. Afterward, the fleshy part of the chin is restored to its original position with a less prominent chin when the swelling dissipates.

[previous page] [next page]