Enhancement of a short chin is usually done with an implant. With larger chin deficiencies in young patients, some plastic surgeons will cut and move the small chin bone forward (osteotomy) instead. Either approaches is highly successful for a better balanced chin and which one is chosen is based on the degree of chin deficiency, the surgeon's experience, and how one feels about an implant vs cutting the bone.
In cases of extreme chin deficiency, neither an implant or an osteotomy may be enough. The amount of chin shortness does not permit these conventional methods of chin augmentation to work. The thickness of the chin bone may be less than the chin deficiency or off-the-shelf chin implant options are simply not large enough.
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In such cases, the underlying diagnosis is that the jaw is underdeveloped as evidenced by a large underbite. This type problem is best treated by a preparatory course of orthodontics and subsequent jaw advancement surgery. After which chin augmentation may not be needed or it can be done at the same time as jaw advancement if prediction tracings demonstrate that it is needed. However, patients may not have the finances or health insurance (or it has been denied) for this ideal approach or they are older and simply don't want to go through this multi-year treatment plan.
One alternative approach in these large chin deficiencies is to combine an osteotomy with an implant. This type of extreme chin surgery gives a chin advancement that can not be achieved by either approach alone. Adding an implant to a forwardly advanced chin segment adds little extra time and no extra recovery to the procedure. The implant should be secured onto the chin bone with screws so it will not shift after surgery.
I have extreme chin surgery numerous times without any postoperative problems. No infections, implant shifting, or problems with the bone healing have occurred.osteotomy healing. Feeling to the lip and chin will be affected for awhile, primarily due to the osteotomy, but I have had no long-term complaints about permanent numbness.
Extreme chin surgery should only be used for those patients who cannot undergo the standard treatment for a short jaw and chin but still desire better facial balance. A large underbite will still exist after surgery. This combination of chin osteotomy/implant offers a less expensive option than a custom-design implant with less implantation of synthetic material.
Extreme Chin Surgery For the Very Short Chin
Dr Barry Eppley is a premiere board-certified plastic surgeon in private practice in Indianapolis, Indiana at Clarian Health Systems. (http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com Dr. Eppley can be heard on his weekly radio show, Doc Chat, on WXNT 1430AM Indianapolis on Saturday afternoons.
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