Reviewed by Dr. Roger C. Mixter

A face should have a harmonious balance to it, and the importance of the chin to this balance cannot be overemphasized. If you have a weak chin or one that is out of balance with the rest of your face, chin augmentation surgery can make your chin more prominent. This procedure can create a greater sense of balance for a face where the chin is weak, receding or not well defined and can improve your looks immeasurably.

Chin Augmentation Techniques
In the most common type of chin augmentation, an implant is placed over your natural chin to increase the prominence of the chin. This is called mentoplasty. Alternatively, a surgeon can perform a chin advancement (genioplasty or sliding genioplasty) procedure, in which the chin portion of the jawbone is separated under the teeth and is brought forward, again creating a more prominent chin. The bone is then fixed into its new position with metal screws and plates. (Genioplasty can also be done to correct a too-prominent chin by removing a portion of the jawbone under the teeth and moving the chin portion backward.)

Someone with a severely underdeveloped jaw, where the upper and lower teeth do not match up correctly, can also undergo a surgical procedure that cuts through the lower jaw and brings the front part of the lower jaw forward, correcting the bite and improving the prominence of the chin. This is a more invasive surgery than either mentoplasty or genioplasty.

Your surgeon may ask you to have several x-rays of your face and head taken to determine which procedure is best for you.

If mentoplasty is the best technique to deal with your chin, your surgeon can insert the chin implant in either of two ways. He or she can insert the implant through an incision in your mouth between your lower lip and teeth (an intraoral incision) or through an incision made underneath your chin (a submental incision). The implant can be either sutured or screwed into place or left loose, in which case bandages will hold it in place until the chin heals.  Sliding genioplasty can also be done either through an intraoral or submental incision.

If you have a weak chin, you may think you need only a chin implant, but for many people, chin augmentation alone will not completely bring the face into a pleasing balance. Chin implant surgery is often performed in conjunction with liposuction under the chin, jaw augmentation, cheek implant surgery and rhinoplasty.

The reverse is also true; many people who go to a cosmetic surgeon seeking only a rhinoplasty may find they also need chin augmentation to create the best look for themselves. A good cosmetic surgeon will examine your facial structure and determine which procedures are needed to achieve the look you want.

Types of Chin Implants
The implants used in chin augmentation are usually synthetic. Some surgeons use bone or cartilage taken from elsewhere in the body, but there is a higher risk of infection with this kind of implant.

The most commonly used type of synthetic implant is made of solid silicone, a flexible substance widely used in medicine. Unlike silicone gel breast implants, solid silicone implants cannot rupture or leak silicone into the body. Other materials that are widely used in chin augmentation include polyethylene, expanded polytetrafluoroethylene (ePTFE or Gore-Tex), and an acellular dermal matrix product (Alloderm).  Synthetic implants come in several shapes and sizes and can also be custom made.

About 14,600 chin implantation procedures took place in 2006, according to the American Society of Plastic Surgeons.

Are You A Candidate For Chin Augmentation?
Chin implant surgery is relatively minor, but it is still surgery. You should be in good overall health and free of any active disease, such as uncontrolled diabetes or heart disease.

You must also be free of bone disorders and have not used Accutane, a drug to treat serious acne, in the previous 6 months. Accutane can cause excessive facial bone growth, which could complicate chin augmentation surgery, and also makes excessive scarring more likely. Patients who have bone disorders or are using Accutane should discuss this carefully with their surgeon.

You should be in good mental health, so that you are prepared for the chin implant surgery and recovery, which can be slow and uncomfortable. Some people become depressed after a surgical procedure, so it is important to ensure this temporary depression does not worsen any emotional problems that may already exist.

You must also have reasonable expectations. The effect of a chin implant on your face may be dramatic or very subtle, depending on many factors including the natural shape of your face. But cosmetic surgery can only change your appearance; it cannot change anything else in your life. If you are considering a chin augmentation, you should examine chin implant before-and-after pictures with your surgeon to make sure you both agree on what you want to look like after the chin augmentation surgery.

Finally, health insurance will not cover the costs associated with cosmetic chin augmentation surgery. However, financing can often be arranged.

How Chin Augmentation (Chin Implant) Surgery Is Performed
Chin augmentation with an implant will take from 45 minutes to 2 hours to complete. If other procedures, such as a rhinoplasty or liposuction under the chin are performed in conjunction with the chin implant, surgery will take longer.

There are several phases in chin augmentation:

Preparation: During the “prep” phase, your surgeon marks you to indicate where the incisions will be made. The location, length and direction of these incision lines will be dictated by the technique being used. You may have an intravenous (IV) line started at this time, and you will be hooked up to monitors to keep track of your heart rate and other vital signs.

Anesthesia: The choice of anesthesia should be discussed between you and your surgeon well before your surgery. Some surgeons may use a local anesthetic and a sedative if chin augmentation is the only procedure being performed. However, if additional procedures are being performed with the chin augmentation, your surgeon may recommend general anesthesia, where you sleep through the procedure.

Surgical Procedure: Once anesthesia has been administered, your surgeon will carefully follow the premarked incision lines and make the pocket between the muscles and skin of the chin and the front of the jawbone. Once the chin implant has been inserted or the bone advanced, the incisions are closed. A dressing is then applied to protect the incisions, if a submental approach was used.

Recovery: After your chin augmentation procedure, you will be awakened and moved to a recovery area where staff can monitor you for about 2 hours. You may experience some pain or nausea at this time. The staff can give you pain relievers or antinausea medications.