Chin augmentation can also be used to help older patients who complain about the appearance of their necks. “It’s not uncommon to develop a more obtuse angle to the neck with age, as opposed to the nice, acute angle that’s aesthetically pleasing and associated with youth,” said Etai Funk, MD, a double board-certified facial plastic surgeon and otolaryngologist in Houston. “Sometimes, combining a neck lift or neck lift/face lift with a chin implant can really enhance the angle of the neck.” Chin augmentation is also used to help patients with microgenic or retrognathic chins.
Explore This IssueAugust 2012
Careful listening helps facial plastic surgeons determine patient goals, while photographic imaging is often used to show patients various treatment options. “I use Mirror Imaging [software] to show patients what they may look like with a chin implant,” Dr. Dayan said. “I don’t often say to someone, ‘You need a chin implant.’ But if I look at them and listen to them long enough, I can usually understand their concerns, and it may be that a chin augmentation would be helpful. In that case, I might use the imaging software to show them how they might look after an augmentation.” If the patient likes the “after” appearance, Dr. Dayan will explain that a chin implant can give them their desired look.
Joseph Shin, MD, chief of the division of plastic and reconstructive surgery at Montefiore Medical Center in New York City, agrees that few patients initially understand which surgical procedure will most effectively give them the look they desire. “What they want is often not exactly what they need, and what they need sometimes isn’t exactly what they want.” Taking the time to show patients alternatives can make all the difference in later patient satisfaction.
Dr. Spiegel lets prospective patients handle sample implants to develop a better understanding of the possibilities available with chin implantation. “After we talk about where we’d like to add volume, I show people several different implants and talk about how each can achieve different things,” Dr. Spiegel said. “I can then show them how the implant I recommend will do just that.”
More Than Science Alone
Determining the optimal degree of chin projection is part art, part science. While a number of mathematical formulas exist to help plot ideal chin placement, most experienced facial plastic surgeons rely on a mix of math and artistic instincts when planning chin augmentation.
“There are many formulas that tell you where the chin should be positioned in relation to the nose, the cheeks or the root of the nose. The Gonzalez