Chin augmentation

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [mailto:Newmanm@ccf.org]; Michel C. Samson, M.D., FRCSC, FACS [mailto:samsonm1@ccf.org]

Overview
Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. This operation is often performed at the time of rhinoplasty to help balance the facial proportions.

Chin implants are to build a better profile. Patients’ own bone is donated from ribs and from part of the pelvis (the ilium.) Unfortunately, use of donated bone implants in chin augmentation, even the patient’s own, appears to be associated with a higher rate of infection, even after the implant has been in place for decades.

Chin augmentation is still popular because it’s a relatively easy operation for both surgeon and patient while producing dramatic and noticeable changes in the silhouette of the face. This type of surgery is usually performed by an oral and maxillofacial surgeon.

Potential risks and side effects
The usual complications are relatively minor and include swelling, hematoma (blood pooling) and numbness of the lower lip which usually does not last long. Other, less common risks include infection, bony changes and displacement of the implant.

Chemical compositions
Gore-tex used in plastic surgery and other operations is known by an abbreviation of its chemical name, ePTFE (expanded polytetrafluoroethylene) or Gore S.A.M. (subcutaneous augmentation material.)

ePTFE is used in medicine because it is biocompatible and does not cause problems inside the human body. Because ePTFE is flexible and soft but very strong, it is inserted during operations in trimmed sheets and carved blocks and held to the bone by titanium screws. But because the material is porous, the force that really holds the implant in place is soft tissue and bone growing through and into the implant.

Another chin augmentation implant material is commercially known as AlloDerm and known to physicians as acellular human cadavertic derms. AlloDerm comes from tissue donors; just after death, technicians remove a thin layer of skin and use antibiotics and other substances to remove the cells and donor DNA that may cause rejection. The graft that emerges is often used to cover chin implants. Other typical types of chin implants include silicone implants in varying degrees of softness; silicone elastomers (any of various polymers having the elastic properties of natural rubber) and porous polyethylene implants. Other common implant materials include Supramid, a braided nonabsorbale synthetic suture material in polymer shell and Mersiline, a mesh-like material that provides a scaffold on the bone.