Edelstein Cosmetic

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    The synopsis

    The shape and size of our chins has a greater impact on our overall appearance than most of us would think. A chin that doesn’t project far enough will make our faces appear disproportionate and disharmonious as will an overly short or long chin. In the study conducted by surgeons at the Department of Otolaryngology at SUNY Downstate Medical Center, Vertical Incision Intraoral Silicone Chin Augmentation[1], it was found that 100% of patients who received an implant to augment their chin were satisfied with their results, both functionally and aesthetically.

    How to get better chin definition

    Chin augmentation is designed to enhance the contour of your chin with an implant or sliding genioplasty (sliding osteotomy).

    Chin augmentation works by correcting disproportionate facial features. Patients who suffer from an unusually small chin (micogenia), excess chin height, a disproportionate lower jaw (mandible) size (retrognathia or prognathia), or jaw or chin asymmetry are all good candidates for the treatment. Depending on the chin abnormalities and particular goals of the patient, Dr. Fialkov will choose whether to use the sliding genioplasty or implant approach for the surgery. Each technique has its own particular indications and advantages, meaning that the procedure of choice has to be tailored to each individual patient.

    The effects of augmentation mentoplasty are numerous

    The following can be achieved by redefining the prominence of your chin.

    Definition of the facial border

    The chin (and the jawline) is the lowermost feature of the face. Minimal chin projection and a weak contour adversely affect the definition of the lower face, which may blend too much into the neck. By enhancing the chin with an implant or sliding genioplasty, definition of the area is improved.

    A more balanced facial profile

    A more prominent chin can achieve harmony with other features, particularly the nose. All too frequently, patients who are unhappy with the size of their nose choose rhinoplasty as a solution, when in actuality, the prominence of their nose can be “offset” by an enhanced chin. A chin implant or sliding genioplasty creates a pleasing result that satisfies patient expectations. In some cases, a rhinoplasty may be performed as well to optimize facial balance.

    Reverse the effects aging on the neck and jawline

    While chin augmentation is designed to improve the chin for a more balanced profile, our craniofacial plastic surgeon has found that for some patients, another benefit also exists: it can rejuvenate the neck and jawline.

    A neck lift or facelift is recommended for addressing tissue laxity in the area of the neck and lower face. This cosmetic surgical procedure repositions and removes excess skin and fat while also tightening lax muscles. The degree of laxity and droop of facial soft tissues is related to aging, sun exposure, smoking and genetics. A major determinant of the extent of this effect as well as of the success of any face or neck lift is the patient’s underlying bone structure, and in the lower face (jawline) and neck area the mandible (chin bone) is that bone. A weak chin will generally result in earlier and more significant lower facial and neck aging. Often patients can undergo genioplasty as an alternative or an adjunct to facelifting to achieve better and more long-lasting results.

    In recent years, genioplasty has increased in popularity because of its ability to dramatically enhance a patient’s profile, making it more balanced. While younger patients find the treatment beneficial to correct the chin they were born with, other patients undergo the procedure to enhance soft-tissue support and volume lost due to the aging process.

    If you look at the before and after photos of this patient who had a sliding Osseous genioplasty (a technique that involves shifting the bone forward), you can see how her chin isn’t just enhanced—her neck also looks firmer and more youthful, despite not having had a face or neck lift. However, genioplasty to correct facial aging is only suitable for some patients.

    Our skilled craniofacial surgeon can use one of two techniques—sliding genioplasty or chin implant placement—to significantly improve your appearance.

    Every time I look in the mirror I feel like a million bucks. Allana L.

    Chin implants

    The use of alloplastic facial implants for chin augmentation is a simpler procedure than sliding genioplasty, but less versatile. Although the rate of complications in implant chin augmentation surgery is lower than sliding genioplasty, it still exists. The implant approach isn’t as versatile as the genioplasty technique, however, and is usually only suitable for patients with an under projected or receding chin.

    Sliding genioplasty

    Sliding genioplasty is a more versatile technique than the implant approach and is capable of correcting a wide variety of issues. It can be used to treat asymmetrical, overly projected, under projected, and overly lengthy chins. The level of adaptability made possible through genioplasty means that the chin can be treated in three different dimensions. This makes it an ideal approach for patients who present complex chin abnormalities. As such, the satisfaction rate for this procedure is extremely high.

    Are you a candidate?

    Chin augmentation is designed for patients who are unhappy with their chin size, shape or projection and would like to address the issue with surgery. You should be in healthy condition and understand the risks related to your treatment so you can make an informed choice.

    Risks

    Implant related risks

    Implant chin augmentation carries with it a low risk of bleeding, infection, soft tissue irregularities and deformity, a retracted lower lip, and issues related to the implant itself. Dr. Fialkov uses Porex chin implants which are fixed to the underlying chin bone. This lessens the complications more commonly seen with silicone implants, such as migration, malposition, bone resorption, infection and capsular contracture. Surgical experience and meticulous pre-operative planning to ensure the correct size and placement of the implant results in a very high satisfaction rate for this procedure in patients that are appropriate candidates.

    Sliding genioplasty risks

    Although very rare, the most common risks inherent to sliding genioplasty include relapse, bleeding, infection and fixation hardware issues. Injury to the mental nerve, which provides sensation to the lip is an exceedingly rare complication. These complications can be avoided when an experienced and skilled surgeon performs the operation. Our craniofacial surgeon has subspecialty training in the performance of sliding genioplasty and the pre-operative planning that optimizes the aesthetic outcome of this procedure and minimizes risk.

    Consultation

    Facial cosmetic surgery requires the utmost precision and accuracy in the operating room, with changes measured in millimetres. Reshaping and/or moving the chin to improve facial proportion is no exception. Therefore, in order to better plan for surgery and optimize the predictability of results, Dr. Fialkov has his genioplasty patients assessed cephalometrically by Dr. S. Smith, an orthodontist. This means that you will undergo special x-rays that show your chin position relative to the rest of your facial bones and soft tissues. Dr. Smith uses these x-rays to measure the ideal position of the chin and how far it needs to move forward, backward, up or down to achieve optimum facial proportion. By taking these measurements from x-rays preoperatively, Dr. Fialkov is able to move or augment your chin with maximal precision. This is a unique service that Dr. Fialkov is able to offer because of his expertise in craniofacial surgery.

    When compared to photoimaging, this technique yields more accurate results because it is based on precise measurements taken from x-rays of your actual bone structure, which serves as the foundation of your facial contour.

    As a consequence of this process and the resultant predictability of the outcome the satisfaction rate amongst Dr. Fialkov’s patients is extremely high.

    Preparing

    You’ll receive a list of care instructions to follow in order to make your surgical experience a safer and more effective one. You may need to stop smoking and drinking, as well as avoid any medications that could promote bleeding (such as Asprin and Advil).

    Your surgery

    General anesthesia is administered.

    Chin implants

    An incision is made and a pocket created in the chin to place the chin implant. In his experience working with patients surviving trauma and complications, Dr. Fialkov has found that affixing the porous polypropylene implant to your bone prevents migration and other related complications. Once the implant is positioned and affixed to your bone, the incision is closed and dressed.

    Sliding genioplasty

    Sliding genioplasty involves making an incision in the chin bone then releasing the bone so that it can be repositioned to achieve the desired result. The bone is secured in place, then the incisions are closed and dressed.

    Following your surgery

    You’ll be swollen, bruised and in some pain after your surgery. Pain can be controlled with prescribed medications. Recovery following sliding genioplasty is more intensive and longer than chin implants.

    You may need to be on a liquid diet or consume only soft foods as you recover, as you may find that it is difficult to chew.

    Your results

    Your results are permanent. You’ll enjoy better proportions of your facial contours, with an enhanced profile that makes you look more attractive, and even younger.



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