Chin & Cheek Implants

If nature gave you less-than-ideal facial bone structure - perhaps your chin recedes or your cheeks seem to o fl at or hollow - your facial features may not appear balanced. Well-de fi ned cheekbones and a strong chin not only convey beauty and strength, they can also draw attention away from facial flaws that might otherwise be noticeable.

Facial implants will give you a safe and long-lasting way to strengthen chin or cheeks without extensive surgery. In the United States each year, facial cosmetic surgeons safely and successfully perform an estimated 30,000 chin implantations and 10,000 cheek implant procedures.

What Are Facial Implants?

Facial implants, most commonly done for the cheeks or chin, are materials that are shaped and inserted below the skin and muscles. Cheek implants will plump up the cheeks. Chin implantation, sometimes referred to as mentoplasty, genioplasty, or chinplasty, makes the chin look stronger and more prominent. For surgery to place solid implants into your face, your doctor will use carefully shaped materials to build up flat areas, giving you a more attractive, proportional, and youthful face. Facial implants are considered permanent unless, for some reason, you choose to have them removed.

Facial Implant Materials

Facial implants can be made out of bone, fat, or other tissue from your body (autologous tissue) or from a donor source. Besides human or animal tissue, metals (such as titanium), ceramic materials, and various types of synthetics have been used. Some are injectable - liquids or semiliquids available as pastes, gels, or oils. Injectable implants aren't usually as long-lasting or as effective as solid implants.

Most facial cosmetic surgeons prefer to use synthetic rather than autologous or donated tissue for several reasons. Synthetic implants come in all sizes, shapes, and strengths. They can be tailor-made for elasticity and durability. There's no need to remove tissue from other places on your body; thus the procedure doesn't take as long and is easier on you. Most synthetics can be custom-trimmed for the very best fit. And the capsule that forms around synthetic implants makes them relatively easy to remove in the unlikely event they need to be replaced.

The most common synthetic facial implant materials are the polymers silicone and expanded polytetrafluoroethylene (ePTFE, often sold as Gore-Tex), Polymers - giant molecules made up of smaller molecules - are sometimes referred to as "plastics," but they can be made of organic materials, such as rubber or cellulose, as well.

Silicone, a combination of the elements silicon and oxygen, is sometimes called "synthetic rubber," although it's more durable than natural rubber. Implanted in solid form in facial implants, silicone is strong and causes no toxic or allergic reactions. Most doctors consider silicone, as manufactured today, to be safe and long-lasting. Solid silicone implants have been safely and effectively used in facial implants since the 1960s.

A carbon-based polymer with hundreds of uses, ePTFE is prized for its water resistance and "breathability." In fact, ePTFE might be part of your wardrobe - in your hiking shoes or raincoat, for example. Like silicone, ePTFE is safe and long-lasting.

Are You a Candidate for a Facial Implant?

	Chin implant with facelift. An implant improves the profile and also adds balance in a frontal view.

A chin implant can make a dramatic difference in the overall harmony of your facial features. Since a weak chin makes the nose appear bigger, patients seeking rhinoplasty - a much more extensive procedure - may find that with a chin implant the nose looks more normal in size.

If your chin or cheeks are out of balance with the rest of your face and you're in good health, you may be an excellent candidate for facial implants. Age can be a factor; doctors generally prefer to perform facial implant surgery only on people who have reached adulthood, since bone growth (in teens, for example) can cause implants to shift.

Chin implantation is sometimes postponed and the patient referred to an oral surgeon or orthodontist if there is a severe underbite or overbite. If your incision will be in your mouth, be sure to tell your doctor about any dental or gum problems you might have. As with any surgery, you'll need to stop smoking well in advance of the procedure.

Your Facial Implant Procedure

	In addition to chin implant, this patient had a facelift.

Your doctor may have you prepare for surgery by using an antibacterial facial cleanser or mouthwash, depending on whether incisions will be external or intraoral, for a few days.You'll probably report to your doctor's office for surgery in the morning and go home soon after the operation. Cheek implants take 45 minutes to an hour; a chin implant as little as 20 minutes.

Your doctor will insert your cheek or chin implant using either an intraoral approach, inside the mouth, or an external approach, in which the incisions are made outside the mouth.

Intraoral Approach

Intraoral incisions for cheek implants will be made on the inside of your upper lip, between the cheek and the gums. For a chin implant, the intraoral incision will be near the bottom of the inside lower lip.The surgeon will create a pocket in the area of your face where the implant will go.The pocket will be just the right size to hold the implant and keep it from slipping. It is seldom necessary to attach the implant to underlying tissues or bone. Once the implant is in place, your body will grow tissue, creating a capsule that will hold the implant firmly in place. Nonetheless, some surgeons prefer to secure the implant with sterile permanent screws.

The intraoral approach leaves no visible scar, though some doctors believe it's harder to control infection than with the external approach. Either way, infection is unlikely if you follow your doctor's diet and hygiene instructions after surgery.

[next]