Negative Side Effects of Chin Implants

As much as removal and excision can help bring balance to the profile of a face, addition and augmentation can do the same. This often happens in the form of mandible augmentation, where addition happens in the chin or cheek. This procedure can either be done on its own or in conjunction with a nose-reduction, midface lift, or a facelift. The implant used in augmentation is either the patient’s own bone, cartilage, or synthetic material. The use of a synthetic implant is more common and results in a simpler operation, but it does mean the introduction of a foreign body into the face. However, implants of the patient’s bone also carry risks: infection or re-absorption, though both circumstances are highly unlikely. The incision and implantation are performed under the chin, in the eyelid, or inside the mouth. Implantation through the mouth is used to avoid an external scar, but this process also increases the risk of infection.

Traditionally, plastic surgeons have placed artificial implants in the chin to improve the chin’s shape, size, and projection. Implants are highly customizable and can be placed through very discreet incisions for undetectable scarring.

However, Dr. BYUN does not use chin implants. In his experience, chin implants are subject to a variety of complications. For example, they often shift position, contract, compress, or harden, becoming more difficult to remove. In many cases, they become infected. Chin implants can even become buried into the chin bone due to weight from the mentalis muscle pushing on it (the mentalis muscle controls the central lower lip; it runs from below the lower lip to the lower part of the chin). All of these complications require additional surgery to remove the implant.

BYUN Mandibuloplasty

 World renowned plastic surgeon Dr. BYUN meticulously customizes everyone’s treatments based on multiple factors, all while using his signature 3D muscle repair lift technique.  These include, the specific anatomy of your face, the skin, muscle tissue, and your facial expressions. Dr. BYUN does not do silicone implants or chin filler since they have high complications such as migration and calcification. Dr. BYUN’s solution to a chin augmentation without placing an implant is to stretch and lift the mentalis muscles/correct the chin with a Zone II (mouth area, chin, and jaw) surgery. An avid believer in the power of the chin to influence the face’s expression, Dr. BYUN is confident that his approach delivers the desired improvement while protecting patients from serious complications. Patients who seek chin implants usually have a recessed, small chin, either set backwards or short in height. These patients usually have a very strong chin muscle and imbalance is caused over time. It is pertinent to address the muscle of the chin such as the mentalis muscle and its function to the surrounding mouth muscle. 

Chin muscle surgery is something Dr. BYUN performs frequently. He does this without cutting the bone. Many oral surgeons insist on cutting down the bone and plating. During surgery, Dr. BYUN creates a tiny incision inside the lip and inserts an endoscope (a long, slender tube with a camera at the end). The endoscope helps him to observe the internal tissue in more detail. He then uses a special instrument to stretch and lift the mentalis muscle and fill the space with the patient’s natural tissues. Dr. BYUN believes that few other surgeons are able to achieve the natural-looking results he can with his tried-and-true techniques. As Chicago’s top plastic surgeon, Dr. BYUN did many of these bone advancement surgeries at the children’s memorial hospital where he saw many collapses, where the muscle overrides the new shape, ie, it does not last over time.  Dr. BYUN makes the chin larger or smaller without using an implant.  Most of the time patients want to achieve a leaner and sharper chin appearance.  Over the last 15 years, Dr. BYUN has been using a minimal bone shaving technique incorporated with a muscle lifting technique, to produce longer lasting natural results without the long term issues generally associated with silicone implants and fillers. 

Patient Case Study

We have provided a sample copy of an Operative Report. The procedure is subject to change per the patients needs.

PREOPERATIVE DIAGNOSIS:

• Prominent angle of the mandible, bilateral
• Hypertrophic masseter, bilateral mandible

POSTOPERATIVE DIAGNOSIS:

• Prominent angle of the mandible, bilateral
• Hypertrophic masseter, bilateral mandible

OPERATION: Reduction angle of the mandible, mandibuloplasty, bilateral

ANESTHESIA: General

INDICATIONS: The patient is a ___old female who has a prominent angle of jaw. She feels this is more masculine and would like to blunt that angle to that of a more feminine soft oval shape of the face.

OPERATIVE PROCEDURE

After induction of general anesthesia in a supine position, she was prepped and draped in the usual sterile fashion. 700ml of tumescent fluid was applied to the abdomen where 10 minutes of Vaser using the ring probe at the set up of 80% were carried out. About 1:1, 700ml of fatty aspirates were taken out through the umbilicus incision. Then, the suprapubic area incisions were closed using 5-0 Prolene. Next, a stab incision at the submental area as well as the post aurlcular area was made. 200ml of tumescent fluid was injected and 4 minutes of Vaser time was utilized using a 2.9mm cannula at the setting of 70%. Using the 3 ring probe 200ml of fatty aspirates were taken out from the neck and chin region. The incision was closed using 5-0 Prolene. A bulky dressing was applied. A garment was applied to the body. The patient tolerated the procedure well, was extubated and was transferred to the Recovery Room in good standing.

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Chin Augmentation Surgery Recovery

Keep all bandages, splints, and wraps intact for 48 hours/ This time is crucial in creating the desired results. After 48 hours, remove and discard gauze that may contain dry blood. Follow the instructions about showering and incision care found previously.

Cleanse any uncovered incisions 3-4 times a day using clean gauze soaked in saline water (found at your local pharmacy) and apply Bacitracin to incisions. After showering and cleansing incisions, re-apply ace bandage compression wrap. Wear the ace bandage day and night for one week following surgery.

Following your follow-up with Dr. BYUN, wear the compression wrap at night for three weeks. This helps the skin from sagging and aids in reducing swelling. Dr. BYUN may adjust this schedule depending on your progress. *In most cases, the ace wrap is applied for compression. Begin by cutting a clean ace wrap in half. Place the ace wrap flat under the chin/jaw line area and wrap around your head and close using the Velcro attached to the wrap. Wrapping should not be too loose or too tight. Compression should have a gentle firmness in order to be effective*.

FAQ

Q: Why does Dr. BYUN not use chin implants for his chin augmentation surgery? How does he make the chin project outward without an implant? 

A: Dr. BYUN does not use silicon objects that are foreign to the body in the chin area. Why? Because 100% of the time, they will move around in your body after they are placed. This is because it extrudes out of the patient’s skin and 25% of all cases of these implants become infected. The implant erodes into the bone due to the weight that it bears from the muscle called the mentalis that pulls it down. 

The BYUN Difference is a process that does a natural augmentation by relaxing the muscle. The chin is a powerful yet delicate part of the body and his approach protects the patient. By using a small endoscope, a single 1cm incision inside the lip, and a special instrument to stretch the muscle as well as lift the mentalis muscle, the patient’s new chin will be wrinkle free and filled with natural tissues. There is no other cosmetic surgeon that can make this natural look happen! 

Q: I have a question about my chin. When I smile, it’s asymmetrical and pronounced, giving it a pointy look from the side. Overall the area underneath my chin is quite chubby/wide so I’m unsure if there is a way to slim everything down. 

A: Dr. BYUN does many surgeries addressing all of your concerns. He never recommends double jaw surgeries to roughly move around the upper and lower jawbones. Instead, he does the procedure with muscle repositioning and a soft tissue release and lift. His techniques are safer and offer long term improvements. Below are some attached photos of recent patients that have received this treatment; they have achieved a better look along the chin and mouth area using his muscle repair technique that was developed by Dr. BYUN at Northwestern University.