Chin Augmentation / Chin Implant Washington DC/McLean/Tyson’s Corner

Introduction

Chin surgery (often called mentoplasty or genioplasty), is a surgical procedure to reshape or reposition the chin. Simply adding chin projection can be accomplished by either placing a chin implant or by moving the chin bone forward. In the majority of cases, actually moving the chin to a new position is advantageous for reasons that Dr. Baker will discuss at the consultation.

Dr. Baker, a plastic surgeon who performs chin implants in Washington, D.C., will help you choose the approach that best suites your goals. The general goal of cosmetic chin surgery is to provide a harmonious balance to your chin and facial features so that you feel better about the way you look.

Dr. Baker’s Credentials for Chin Surgery

  • Professor and Program Director Medstar Georgetown Department of Plastic Surgery
  • Director Medstar Georgetown Center for Facial Restoration
  • Authored multiple chapters, textbooks, and peer-reviewed manuscripts on chin surgery
  • Instructor national courses on chin surgery
  • Invited moderator and panelist on chin surgery at national meetings
  • American Society of Maxillofacial Surgeons Visiting Professor (this is a prestigious honor that selects him to visit other Plastic Surgery Departments in the United States and teach principles of facial surgery)
  • Face Q pioneer and expert on outcomes studies in patient satisfaction in facial aesthetic surgery including chin surgery (one of several practices in the United States selected to participate in this study funded by the Plastic Surgery Foundation).
  • Training in plastic surgery, maxillofacial surgery, and craniofacial surgery provide him the tools to perform a complete assessment of each patient’s facial structure. He is trained in all modalities of addressing your problems, so he is not limited in the solutions he can provide to address your concerns.

Am I a Candidate for Chin Surgery?

facial_implant-2Before undergoing chin implant surgery in Washington, D.C., read the following to decide if this is the ideal procedure for you:

What will the chin surgery do? The majority of patients who inquire about chin surgery are seeking to add projection to their chin. Having a recessed chin can compromise the facial profile because of inadequate projection, laxity of the tissue in the chin and neck, and less linear distance from the neck to the chin which compromises aesthetics. Many patients feel that they need a neck lift, but after an assessment, realize that they would actually benefit much more from a chin advancement. The advancement adds definition to the jawline, tightens lax tissue, and accentuates the definition of the neck jaw angle. Many of Dr. Baker’s patients who have had a chin advancement procedure have soft tissue benefits similar to that of a neck lift: perioral lines are smoother, skin under the neck is tightened, and jowls are diminished.

Will chin surgery make my nose look smaller? Augmentation of the chin will soften the appearance of a larger nose. Projection of the nose and chin are intimately related and frequently patients who complain of large noses will benefit from advancing chin projection. If necessary or requested, both a chin and nose procedure can be done at the same time.

Can chin surgery change my facial shape? The chin can also be lengthened, narrowed, widened, tapered, or shortened to change facial shape from square to oval or shortened to bring a long face into balance. Frequently men desire to masculinize their face or women desire to feminize their face through surgery of the chin.

Why do I have a small chin? Almost everyone in the Washington DC – McLean area has had orthodontics or has their children in orthodontic therapy. Orthodontic therapy corrects a malocclusion and the most common malocclusion is an overbite. This means the lower jaw is recessed and the upper teeth are ahead of the lower teeth. To correct the bite the upper teeth are retracted to meet the lower teeth. As upper teeth are tipped back to meet the lower teeth, the upper lip follows the upper teeth and moves posteriorly giving the nose a prominent look. An option to avoid this is to surgically advance the lower jaw, but many patients are either not aware of this option or do not wish to undergo this procedure. As a consequence, after orthodontic therapy, the occlusion may look great, but the facial proportions are often compromised giving the patient the appearance of a large nose and a small chin

Orthognathic camouflage Some patients who had their overbite corrected orthodontically (see above) to achieve a good occlusion will complain that their nose looks too big and they have no chin. As these patients age, they may see laxity in their necks at an earlier age than their peers who have a more balanced jaw relationship. This type of facial imbalance can be corrected by performing nose and chin surgery to reduce the nose and augment the chin to restore facial balance. It is beneficial to have a person do this evaluation who is competent in jaw surgery as well because in certain cases, jaw surgery is an option that should be discussed with the patient.

Evaluation

Before your genioplasty or chin implant procedure, Dr. Baker will perform a comprehensive evaluation of your face, chin, occlusion, and soft tissue envelope. The factors that go into his treatment plan include soft tissue support and how to optimize the rejuvenation effect of your chin surgery. Also, he will evaluate your occlusion to see whether lower jaw surgery would be an option to achieve the same result. Most patients will defer jaw surgery but it is important that they are informed of the pros and cons of jaw surgery vs. chin surgery if both procedures are an option. In evaluating your face, Dr. Baker will also make recommendations on how the chin surgery should be performed to optimize your facial dimensions based on your current facial form and shape. Ultimately, the procedure performed is your choice, but Dr. Baker will make sure that your choice is based on a discussion of all aspects of chin surgery and facial form. Three-dimensional imaging is performed to allow you to get a sense of the proposed result. The consultation is meant to be an engaging interaction to help you determine the best procedure for your individual goals. Dr. Baker will also give you digital copies of the articles and chapters he as written on chin surgery for you to learn more bout the procedure.

What Is Chin Surgery?

Chin Implant With a short incision under the chin or inside the mouth, Dr. Baker can place a chin implant directly on the bone. For a chin implant, the incision may be inside your mouth, along the crease that joins your lower lip and gums. An incision just beneath the chin is another alternative that may be recommended.

Surgery will usually require about one hour. Before the surgery, Dr. Baker selects the proper size and shape implant to enhance your appearance. He then inserts it into a pocket over the front of the jawbone. The small incision to create the pocket and insert the implant is placed inside the mouth (along the lower lip) or in the skin just under the chin area. The implant is then secured with a titanium screw to prevent postoperative movement or malposition. Although an implant will add projection, it will not correct asymmetry, add length, tighten neck tissue, or allow modification of the labiomental crease (the groove between chin and lower lip).

Bony Genioplasty The bony or osseous genioplasty is when an incision is made inside the mouth and the bone that makes the chin is actually moved into a new position. The jaw is not broken, only the chin button is moved. Therefore, there are no restrictions on diet and no limitations on mouth opening. The advantage of this technique is that it allows new chin positioning with control of the labiomental crease and allows for three-dimensional movement. In a genioplasty the bone is being moved forward, and the muscles and tissue of the neck that attach to the back of the chin are being pulled tighter. This tightening of the soft tissue under the chin has a rejuvenative effect on the soft tissues of the neck resulting in a more youthful appearance. Once the chin bone is in its new location, a titanium plate is used to secure it in its new position.

Preparing for Your Surgery

Dr. Baker will give you specific instructions to prepare for the procedure, including guidelines on eating and drinking, smoking, and taking and avoiding certain vitamins and medications. Carefully following these instructions will help your surgery and your recovery proceed more smoothly.

Whether Dr. Baker performs your chin implant procedure at Washington D.C.’s Georgetown University Hospital (Washington D.C.), Inova Fairfax Hospital (Falls Church, VA) or an ambulatory surgical facility (McLean, VA), you should arrange for someone to drive you home after your surgery.

Anesthesia

Anesthesia administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Dr. Baker will recommend the best choice for you.

Risks and complications

These are fortunately are rare, however they may occur, and it is important for the patient to be aware of these prior to undergoing a procedure. In genioplasty the following risks and complications may occur: excessive bruising, numbness of the lower lip, infection, postoperative asymmetry, and failure to meet patient expectations.

Recovering from Chin Surgery

After your chin implant surgery in Washington, D.C., expect that your chin will be frequently taped to minimize swelling and discomfort. If an intra-oral incision is used, the sutures will dissolve on their own. If the incision is made under your chin, your sutures will be removed within 1-2 weeks following your surgery. While the initial outcome of plastic surgery with facial implants is noticeable almost immediately, it may be obscured by visible swelling, which can take several months to fully dissipate. Some temporary numbness is usually present on the lower lips after chin surgery but typically returns to normal within several weeks.

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