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Chin augmentation is a frequently performed procedure to
help balance a face with a weak or recessive chin. If the occlusion
(bite) is properly aligned, but the chin is recessive, then the
patient is a good candidate for chin augmentation with a synthetic
implant. The procedure can also be done by cutting and repositioning
the bone. In my office we most often use a silicone rubber implant
coated with Gore-Tex™. It is shaped to wrap around the normal contours
of the chin. It can be placed through a small incision under the
chin or from within the mouth. While any implant material runs a
risk of infection and consequently needs removal, it is very infrequent.
Today the emphasis is on anatomical implants that wrap around the
chin as opposed to the smaller implants that just sit in front of
the chin. There are several different styles and sizes available.
Also, special chin implants are often used to fill out natural
defects from aging. The idea of using implants for the aging face
is based on the general loss of volume we sustain as we age.
When the chin is excessive in length, or there is significant
maloclusion (the teeth do not align properly), then treatment requires
resetting the bone. I prefer to refer these patients to an oral
surgeon who usually works in conjunction with an orthodontist.

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A typical example of a slightly
weak chin, coupled with a slight nasal hump. The chin augmentation
is probably more important, than the rhinoplasty in balancing
out the face.
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By performing a chin augmentation,
a subtle rhinoplasty, and plumping the pre-maxilla under the
upper lip, the patient has a much more pleasing and attractive
profile.
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A young man with a slightly
weak chin and drooping nasal tip has a more harmonious appearance
with a chin augmentation and subtle rhinoplasty, mainly tip
work.
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While cheek augmentation has become increasingly popular,
it is still not well appreciated. The cheekbones also help balance
the face. While the chin tends to frame the mouth, the cheeks frame
the eyes. Full or high cheekbones are not only attractive, augmentation
of the cheek area can also help fill the face and reduce changes
associated with aging. (I believe we will see significant advances
in the development of facial implants to deal with the problems
of the aging face.) The implant shape is determined pre-operatively
during the consultation. There are several different shapes and
sizes which may be utilized depending on what we want to accomplish.
Occasionally, this procedure can be combined with fat-grafting to
achieve the enhanced results. The cheek implants are the same type
of material as used with the chin. The implants are most often placed
through a small incision inside the mouth. There can be a considerable
amount of swelling associated with cheek augmentation - somewhat
like that associated with the removal of wisdom teeth. Most of the
swelling subsides during the first week, though there may still
be persistent swelling for another week or two. This will subside
and the implant will stabilize and fix in place. The sutures that
close the incision site inside the mouth are absorbable and do not
require removal. It is advisable to be on a liquid diet for the
first day and soft, smooth foods for the next day or two to avoid
irritation around the incision site.
Once the healing process is completed the new implants should
feel like a normal part of the patient. Neither the patient nor
anyone else will be able to tell that there is an implant in place.
The ultimate result will provide an enhanced facial contour and
in appropriate cases a more youthful appearance. It is important
to note, that should any problem occur, including dissatisfaction
with the appearance, the entire implant is removable as there is
no degradation of the materials.

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This patient initially thought
she needed her nose made smaller, however, cheek augmentation
balanced out her face, made her nose fit better, and gave
her an overall more glamorous or attractive appearance.
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With the slight flatness
of the cheeks and general fat loss that comes with age, the
face sags and looks older. With cheek augmentation, the face
is not only better contoured, it gets a "lift" and the patient
looks more youthful, as well as more attractive.
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A young patient subtly improves
her appearance with cheek and chin augmentation giving a more
sophisticated look.
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