Sydney plastic surgeon DR MARK KOHOUT explains the methods available for reshaping the chin.

The shape and size of the chin can be remodelled in two ways: either by placement of an implant or by reshaping the chin bone itself. The chin can be made larger, longer, or smaller.

CHIN IMPLANTS

The two most common substances used are Silicone and Polyethylene (Medpor).

Silicone is easy to shape if an implant needs an adjustment. One advantage of silicone implants is the ease with which they can be inserted but because they do not allow tissue ingrowth, they can “float”or shift and may not feel like they have become a part of the body.

I use Medpor implants for chin augmentation almost exclusively because it is a porous substance that allows the tissue to grow into and fixes firmly to the underlying bone – this makes the implant virtually indistinguishable from your own bone and is my preferred implant. To fix the implant in place, an incision is made inside the mouth, eliminating external facial scars.

Chin implants are popular with men who are trying to achieve a stronger, more masculine look. Women usually choose this type of surgery to balance their facial features. Many young people seek facial implants because they add definition and character to their face, while older people are combining implant surgery with other facial surgery to complete the look they desire. For instance, a chin implant may enhance the effect of a facelift by merely strengthening the definition of the jawline.

GENIOPLASTY

Genioplasty is an operation designed to change the shape and protrusion of the chin. This simply means the fashioning and shaping of the chin point and controlling its projection in relation to the other facial features such as the lips and the nose. The bone of the chin can be divided and moved independently of the teeth and gums. In this way, it is possible to bring the chin forward to increase chin definition or it may be moved back to reduce the prominent chin. It is also possible to alter the chin shape and configuration, particularly reducing the wide square chin into a more finely shaped chin. Genioplasty is usually performed under general anaesthetic as a day surgery procedure. The commonest variant of this operation is the advancement genioplasty, in which the chin is repositioned forward to correct a weak or under projected chin. It has an effect similar to placement of a chin implant.

CHIN REDUCTION

Many people, both men and women have a strong chin, which they do not like. This may be a chin that is too wide-looking from the front, or a chin that protrudes too far forward when seen from the profile. A combination of a chin that is too wide and too broad can produce the “Chesty Bond” look. Many men do not consider this look desirable and the look is particularly unsuited to most female faces. Chin reduction can therefore be helpful in balancing the proportions of the chin and the lower face generally, to the rest of the face. Dividing the bony chin from the rest of the lower jaw and sliding the chin point back perform chin reduction. This manoeuvre can be combined with reshaping of the chin point if desired. The entire operation is performed from within the mouth and no external incisions are necessary. No external incisions means no visible scars.

Sometimes, the prominent chin is a sign that the whole lower jaw (mandible) is too large. In this case, the prominent chin is usually accompanied by an abnormal bite or teeth that do not meet in the correct way. Should this be the case, a detailed assessment will be required to determine whether the management of this problem needs to involve orthodontic treatment as well as surgery.