Chin Augmentation

CHIN IMPLANT

 

When one considers the substantial impact a chin implant has on overall appearance, it is surprising how few people seek information on this minimally invasive cosmetic surgery. Both balance and proportion are recognized as essential fundamentals of beauty. With the exception of rhinoplasty, perhaps no single plastic surgery contributes more to balance and proportion than a chin implant.

 

Chin implants add definition to the jaw line and improve overall balance of the face. When patients come to our office seeking facial plastic surgery, it’s not uncommon for them to focus on a single aspect of their appearance rather than the overall picture. For example, a patient dissatisfied with the size of their nose seeking rhinoplasty (nasal surgery) may actually be talking about a nose that is out of proportion to the face. Patients who perceive their nose as being too big for their face might be surprised when correcting the chin proportion enters into the equation. Because a chin implant can improve overall balance and restore loss of a clearly outlined profile, chin implant surgery can be a most rewarding facial plastic surgery.

When discussing contouring procedures the best place to start is by looking at before and after photos to see just what can be accomplished. As you will see in our photographs, many patients combine the contouring of a chin implant with a facial rejuvenation procedure such as a facelift to eliminate a “saggy neck” or “turkey wattle” to tightening of the jowl area. Others come to discuss neck liposuction and fat injections, which can easily be combined with chin implant. Fat injections can be used in many areas of the face including the smile lines and for lip augmentation.

Sometimes men ask for a stronger looking chin. Once thought a beauty procedure sought by only wealthy women, men in today’s competitive corporate workplace are increasingly seeking facelift procedures to restore a younger look that more typifies their energy level. Men also frequently ask about brow lifts for correction of frown lines between the eyes or blepharoplasty for improvements in bags under the eyes.

Patients also learn about chin implants when they seek information about improving superficial skin wrinkles in the chin area with a chemical peel, laser surgery or similar skin resurfacing procedure. Lip surgery can also be performed in conjunction with a chin implants.

A good surgeon, knows that his responsibility is to evaluate not only the areas of concern but also the motivation behind the requests. It goes without saying, a cosmetic surgery won’t save a failing marriage. Similarly some patients not ready for cosmetic surgery are better served with conservative measures, such as Botox for fine lines and wrinkles or Collagen for crows feet. Patients who educate themselves about facial rejuvenation know when and if the time is right to proceed.

An important first step toward any cosmetic surgery is to have a facial plastic surgeon assess the entire picture before making specific recommendations. At an initial consultation, we will evaluate the bony and soft tissue architecture of the face, including the proportion and balance of the face, nose and chin. We evaluate the amount of fat in the neck area, the elasticity of the skin and the textural qualities of the skin. Skin type, ethnic background and age are important factors influencing the outcome of surgery. Together we may discuss many alternatives before determining if a chin implant is right for you.

Chin implant is a safe, effective procedure performed to restore balance, proportion and a younger appearance. As with all facial plastic surgery, a thorough health assessment and realistic expectations are prerequisites. Your understanding of instructions and routines is essential to a successful final result.

BEFORE SURGERY

At your preoperative appointment our nurse will provide all the instructions for you to follow before and after surgery. On the business day prior to the operation we ask you to call to confirm your arrival time for surgery. Upon arrival for your surgery, you will talk with a nurse (who will start an IV), discuss anesthesia (with local anesthesia and IV sedation you are asleep and comfortable) and meet with your doctor before going to the operating room. A chin implant takes about one hour depending on the anatomy and structure present prior to surgery. If you are having a combination of procedures your surgery will take longer. Recovery time from the anesthetic takes about an hour and you will be discharged about four hours from the time of admission.

 

PREOPERATIVE INSTRUCTIONS

1.     Please avoid any aspirin, aspirin-containing products, or ibuprofen for one week prior to your surgery. Please see our medication list (separate page of instructions) which outlines in detail products to avoid prior to surgery. If you are on any medications that affect bleeding (such as coumadin or warfarin) please notify the office immediately.
2.     Please refrain from tobacco products and alcohol for one week prior and two weeks following surgery. Along with delayed wound healing, persistent skin redness and other complications may persist when tobacco and alcohol are not discontinued.
3.     Please notify us of all routine medications and significant health history. We ask that you remain on your daily medications unless instructed otherwise. At the preoperative appointment, our nurse will tell you which daily medications to take with just a sip of water on the morning of surgery.
4.     At your preoperative appointment you will be given prescriptions for use following surgery including an oral antibiotic (Keflex/Cephalexin), swelling medications and pain medications. Please obtain these prescription medications before your surgery so you will have them ready for use when you return home after surgery.
5.     The day before your surgery, we will ask you to begin Vitamin C 1000 mg (ascorbic acid), which helps promote healing, three times a day with food for one week before and two weeks following surgery.
6.     You may not eat or drink after midnight the evening before the procedure unless instructed otherwise. You may brush your teeth. Your procedure will be cancelled if you do not follow these instructions.
7.     Remove all make-up and nail polish before arriving for your procedure.
8.     Someone must be available at all times while you are here at the clinic for surgery. Someone will need to drive you home after your surgery and stay with you that evening. Transportation to the office for suture removal three days following surgery is also recommended.

AFTER SURGERY

When you wake up from surgery you will notice a chinstrap dressing that may feel a bit tight because of the swelling. This dressing helps minimize swelling and keeps the chin implant securely in place. Following your chin implant, the nurses will ask assist you to meet the discharge criteria: to drink liquids, walk with a steady gait, void, manage your discomfort, and have a responsible adult at home following the procedure. The nurses will review all instructions you will need for care following chin implant.

 

The chin dressing must be kept dry and in place for three days following surgery. You will be asked to come to our Office (not the Surgery Center) on postoperative day three or four for dressing and suture removal. The morning of the suture removal, you may shower and get the dressing wet, which will help with dressing removal at your appointment.

Although most patients describe dressing and suture removal as discomfort rather than pain, you are encouraged to take your pain medication about an hour prior to suture removal. When sutures are removed, small steristrips will be placed to reinforce the incision. These steristrips must remain dry and in place for four days. You may then get them wet in the shower before your second postoperative appointment for steristrip removal.

 

POSTOPERATIVE INSTRUCTIONS

 

Wound care

Keep dressing dry and intact the evening after surgery and for three days following surgery. Notify your doctor if the dressings become loose or fall off.

 

Medications

•     Most patients complain of discomfort more than pain. Use pain medication as directed/as needed. Do not drive or drink alcohol while taking pain medication. Taking pain medication with food helps minimize nausea sometimes associated with pain medications.
•     Start your antibiotic (Keflex/cephalexin) when you get home and one at bedtime. It is not uncommon to have a low-grade fever for 24 to 48 hours following surgery.
•     Start swelling medication when you arrive home and again at bedtime. Then follow package directions. Take with food.
•     Vitamin C (ascorbic acid) helps promote healing. Take 1000 mg three times a day for two weeks following surgery.

Diet

Advance diet from liquids to soft food to your regular diet as tolerated. There are no dietary restrictions for chin implant patients postoperatively.

 

Activity

Rest for entire day after surgery. Sleep with head of the bed elevated or use two to three pillows for one week after surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. No driving for one week following surgery. Two weeks off work is recommended; three weeks off is ideal.

 

Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. Following surgery, our staff will tell you when it is ok to apply sunscreen, cosmetics or facial creams. Avoid unprotected prolonged sun exposure for three months following chin implant to prevent pigmentation of incision lines.

Please Remember!

Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Assistance with daily activities the first two to three days after surgery is recommended.

 

Final Result

Following chin implant, it takes time for the swelling to subside and for the skin to heal. Most patients return to work one week following surgery, however two weeks is ideal, depending on the degree of privacy one is trying to maintain. At two weeks postoperatively, swelling and bruising may be apparent to you but not to many of your coworkers and closest friends.
Final results following chin implant are not apparent for one full year following surgery. After three months, the changes are ever so subtle, although still important. Being perfectionists about our work, you may tell us you are pleased long before the one-year anniversary. However, we request that you follow-up with us at that time for postoperative photographs and so that we can enjoy your final result.