Facial contour

By Mayo Clinic Staff

(Synonyms: chin augmentation, chin reduction, genioplasty, chin implant, cheek implants, malar implants, malar augmentation)

Facial implants

Facial implants for the cheeks and/or chin can bring facial features into greater harmony and enhance their definition and youthfulness. Both types of implants can strengthen the features and profile of the face. Each involves placing synthetic materials deep under the subcutaneous tissue and onto the underlying bone. There are several types of facial implants made of different materials. The surgeon will choose an implant based on prior experience and what is best for the patient.

Cheek and chin implants are distinctive from other cosmetic surgeries in several ways: multiple options; minimal surgical access can often be used to place the implants; and results are often dramatic. Most people are pleased with their decision to have facial contour procedures. Adjusting to a new appearance is a consideration in making a decision.

What to expect

Usually, chin and cheekbone implant surgery is performed through incisions made inside the mouth. In some cases, surgery will be performed through a small incision under the chin. The surgeon will explain which procedure is best. The implants are placed into a pocket or space created under the skin. They may be secured there with small surgical screws or permanent sutures.

In a few cases reducing cheekbones or the jawbone may be the best option. This is done by contouring the underlying bone or removing excess skin and subcutaneous tissue.

Chin alterations
Cosmetic surgery of the chin enhances a person's profile by creating a proportional balance with other facial features such as the neck, lips, nose and forehead. A receding chin, for example, can make an average nose seem large.

A large chin can be reduced with surgery. The surgeon makes an incision inside the mouth and beneath the lower lip and reduces the bone using bone-contouring instruments. Once the incision is closed, special tape may be placed over the chin during the initial healing period. This surgery can be performed alone or in combination with other facial cosmetic surgery, such as rhinoplasty or a facelift.

A small chin can be augmented with a variety of implants, which are inserted through an incision beneath the chin or inside the mouth behind the lower lip. A pocket is created at the tip of the chin and an implant is positioned inside it. The oral approach avoids a visible scar. Once the incision is closed, the chin may be supported by tape for several days to decrease swelling and prevent fluid accumulation.

Another option is to move a portion of the bone at the tip of the chin forward (a sliding advancement genioplasty). This makes the chin more prominent and can also address any needed vertical changes as well. The surgery is performed through an incision inside the mouth in the area of the lower lip. The bone is cut above the lower border of the chin and below the lower front teeth. The chin is carefully detached, moved forward and stabilized with wires, or plates and screws.

Cheek alterations
A number of procedures are available to enhance the cheekbone (malar). These procedures are typically performed through small incisions inside the mouth in the upper jaw area. A pocket is created and the implant positioned and secured.

Special situations
In some cases patients may benefit from a custom implant. Special imaging is used to create a model that is used to fabricate a custom implant for the specific need.

Risks

The risks associated with facial contour alterations may include, but are not limited to:

  • Problems related to anesthesia
  • Infection. Your physician may prescribe antibiotics after surgery to prevent infection of an implant. If an infection develops with the implant, removal may necessary.
  • Extrusion, a condition in which the implant can be seen through the skin, is a rare risk. If this occurs, the implant must be surgically removed. In some cases, the implant may shift or collect fluid, also requiring a second surgery.
  • Swelling and discoloration of the overlying skin may last for several weeks to months.
  • Some temporary numbness or tingling may occur but will usually diminish over time. Permanent numbness is rare.

There have been no reports of medical diseases or disorders caused by using synthetic materials for facial contouring. Some studies have shown slight bone erosion under some implants placed on the chin. Rarely, chin erosion can be significant and even affect the roots of teeth.

This procedure is performed by specialists from Oral and Maxillofacial Surgery and Facial Plastic and Reconstructive Surgery (Otorhinolaryngology).

Key Facts

Anesthesia: General anesthesia or local anesthesia with IV sedation

Length of procedure: 1 to 2 hours

Length of stay: Usually home the same day; overnight stay if performed with other procedures such as facelift or rhinoplasty

Discomfort: Mild to moderate

Anticipate: Bruising up to 3 weeks; swelling may take several weeks to months to diminish with implants; some temporary numbness of the lower lip for up to several months.

Final result: Approximately 4 to 6 months

Duration of results: Lasting

Sep. 12, 2014