Chin Augmentation
Age 34: Chin Implant, Neck Lift, Facial Liposuction
This is a 34 year old female who is 5’4” and 136 pounds who was interested in facial changes. She says that she has always had fuller cheeks and a weak chin and that this has always bothered her. She says that it got worse after having several children. On examination, she had a relatively long midface with a weak chin, poor definition of the mandibular border, fullness in the jowl area on both sides, weakness in the cheekbone area and a very asymmetrical face (the left half is quite different from the right half).
We discussed options at length. We decided to be relatively conservative to start with. I performed a chin implantation and liposuction of the fat beneath her chin. I also performed liposuction of her lower face and transferred this fat to her upper cheek area on both sides as well as to her lower lids. No other procedures were performed.
The difference is quite interesting indeed. To an untrained eye, one might note that she appears “different” but not knowing why. To a trained eye, and to someone who has before and after photos to compare, I note the following:
- Her face is different on global view—the “big picture”. It is more symmetrical, more sculpted, less full and more attractive.
- The creases below her eyes are gone with the fat filler.
- Her jowls and nasolabial creases are improved.
- The side view of her face illustrates the most drama—improved chin projection, better neck angle and overall improved facial balance.
- There is mild collapse of the skin on the medial aspect of her cheeks as we anticipated after the removal of so much fat.
- Look how improved the definition of her jawline is. This was from the implant as well as the liposuction of a thick fatty layer of tissue on top of her jaw bone. This separates her face from her neck.
She is very pleased with her outcome, as am I. We discussed additional levels of refinement (now that she fully trusts her surgeon!) We discussed several options including doing nothing, performing a face lift even at her relatively young age, and transferring more fat to selected areas. I recommended an elegant face lift that I believe will complete her journey and will provide for the best result that is befitting of a young woman her age.
Take home points:
- Facial liposuction requires expert skills and judgment.
- Fat transfer is an “art” and is unpredictable in its take. Fat is more likely to take in the face than in the body. The procedure continues to evolve and someday it may be perfected but right now it is imperfect. However, the downsides are minimal so it is often worth pursuing.
- Chin implants are a powerful tool to enhancing the face of a patient with a weak chin. It improves facial balance and harmony, improves the jawline and the neck as well.
- Her face is still asymmetrical after fat transfer and liposuction. A face is asymmetrical because of asymmetry of the underlying bony structures and this doesn’t change with manipulation of the overlying tissue.
Age: 54 Neck Lift, Neck Lipo, Chin Augmentation
This patient desired a chin implant for a “weak chin.” She was also interested in improvements in her neck area. She is seen here about a year after an anterior neck lift and a “Porex” chin implant. The chin implant was placed on the lowest, most anterior portion of her chin bone and the neck “lift” was performed through the same incision beneath her chin. I contoured her neck by performing liposuction of the area including her jowls, removed a small amount of fat beneath the neck muscle, and sutured the neck muscles together for an improved neck angle and a flatter area beneath her chin.
A chin implant is an impressive method to improve the proportions of the face, add “character” to a weak jaw, and improve the appearance of the neck.
Age: 37 Silicone Chin Implant
Age: 40 Chin Implant and Facial Liposuction
This is a 40 year old female who was interested in facial enhancements. She told me that her face is asymmetrical, her chin is small, and that there was excess fat on her face. Certainly, on initial appearance, she is a very attractive woman and any reasonable plastic surgeon can make an argument that she needs nothing. However, I know her well and understand how she thinks. On careful examination, I can clearly see that her face is asymmetrical–no one has a perfectly symmetrical face. In fact, it amazes me how surprised patients are when I point out their asymmetries. Every human face is different in terms of right and left sides. She has a small chin for sure, and this affects the balance of her face and is partially responsible for her blunted neck angle and the fullness beneath her chin.
She is seen here about one year from facial and neck liposuction as well as the placement of a medium sized POREX chin implant (placed through an incision in the chin crease). Careful examination of her photos reveal a very significant and natural improvement. She was looking for more of a “sculpted” mid to lower face and enhanced facial balance. This was provided with the liposuction and the chin implant. On frontal view you can see the improved overall contour and on the lateral and quarter views you can see the improvement in the neck contour and the enhanced projection of her chin with improved facial harmony and balance.
Points to consider/learn from her case:
1. Facial liposuction is risky business. The potential for irregularities is significant and should only be performed under ideal circumstances by an expert plastic surgeon.
2. The use of a chin implant for those with weak chins is very powerful and beneficial. The potential for complications is higher than most facial procedures (movement of the implant, displacement and infection, among others). I have had great success with POREX implants which is made from polyethylene (suture material). It allows for tissue ingrowth because of its pore like structure. Properly placed, this implant performs exceptionally well.
3. This patient is extremely happy but this is not always the case in patients who request facial liposuction. I have learned over the years that there is a higher proportion of patients who have BDD or Body Dysmorphic Disorder when facial liposuction is requested.
4. It’s never a good idea for a woman to choose too large of a chin implant as this can make for a “manly” appearance to the jaw. It’s always better to choose the smaller to medium sized variety.
5. I love the fact that these multiple procedures performed carefully and artfully make for such a beautiful and natural appearing result. I like when there are nice improvements without the telltale stigmata of surgery.
Age: 53 Silicone Chin Implant
Age: 46 Silicone Chin Implant
