Chin implant genioplasty (chin prosthesis advancement)

The shape of the chin is the result of the addition of two types of structures: an osteo-cartilaginous base (the tip of the mandible, which is fused to the mandibular symphysis) and the soft tissues that envelop these hard tissues (the chin tuft muscle, chin fat and skin).

Chin imperfections can thus relate to its height, width or projection with two types of chin:

• receding chin : this is retrogenia where the chin is underdeveloped. This aspect often enhances the elongated appearance of the nose and can wrongly convey an indecisive or hypocritical air.
• A chin that protrudes too far forward: this is when the chin is too strong, too far forward. This elongated aspect increases the severity of a face and can break its sensuality.

While excess chin volume can be linked to bone (progeny) or fat (double chin) abnormalities, the defects are always related to a lack of hard tissue.

However, there are two ways to bring projection back to an excessively receding chin:

1. or volume is recreated in the soft tissues by hyaluronic acid injection, lipofilling or prosthesis (chin implant advancement);
2. or the short mandible is advanced by surgical genioplasty (osteosynthesis).

Dr Christelle Santini believes that implant-supported genioplasty delivers excellent results, with a less invasive solution than bone surgery.

The latter is necessary in cases of associated malocclusion (e.g. lower retrognathia), which cannot be corrected with a chin implant.

The procedures will differ depending on whether the chin is receding or protruding. A chin that is too short or too protruding necessarily requires chin augmentation surgery.

Several types of chin prosthesis are available: either small central prostheses, or prostheses with lateral fins to widen a chin that is too narrow.

The prostheses are usually made of hard silicone and are very well tolerated.

The first consultation is important, with a medical and aesthetic examination, from the front and the side, on the face at rest and in motion (while speaking, for example). Medical photos are taken to support and simulate the rendering.

In particular, Dr. Santini checks for the correct indications and the absence of contraindications, such as brachygnathia or retrognathia preventing correct dental occlusion.

She listens to the patient to define the desired chin projection and proposes a computer simulation.

She may prescribe additional tests, such as medical imaging or orthodontic check-ups.

An anesthetist will be consulted no later than 48 hours before the procedure.

No aspirin-containing medication should be taken for 10 days prior to surgery.

Unlike chin advancement osteosynthesis, chin implant surgery is simple, minimally invasive and performed on an outpatient basis, usually under general anesthesia.

To avoid visible scarring, Dr. Santini favors an approach hidden in the mouth (invisible scarring) or, failing that, very discreetly under the chin.

She delicately clips the tissues to create a custom-made box, in contact with the mandibular bone, while avoiding disinserting the muscles of the chin tuft (mentalis muscle).

This space corresponds to the exact dimensions of the chin prosthesis.

She will then place the implant and check for symmetry, balance and correct positioning.

The wound is then sutured, with the procedure lasting 30 minutes to 1 hour, depending on the type and number of implants.

A chin support bandage is worn for 5 days, to prevent any displacement of the prosthesis in the chin area. In the event of scarring in the mouth, a mixed diet is recommended for 48 hours, and antiseptic mouthwashes for 5 days.

Avoid hot, acidic or spicy foods for the first 48 hours.

There is no pain, but a little discomfort sometimes associated with the threads, which will reabsorb.

Bruising of the skin is possible, but rare.

The result of genioplasty by prosthesis is immediate. The prosthesis is invisible, thanks to the thickness of the muscles and chin fat that conceal it.

However, you need to wait at least 3 months for the start of stabilized, edema-free rendering.

• Return home the same day.
• Minimally invasive receding chin surgery.
• 5 to 7 days maximum of professional downtime.
• Final result between 3 and 6 months.

What to do before chin implant genioplasty?

• 1 to 2 consultations with your plastic surgeon, including the taking of medical photographs
• Delivery and signature of the estimate, respecting the 15-day legal deadline between the first consultation and the prosthetic advancement genioplasty.
• Anesthesia consultation, blood test, orthodontic check-up if required.
• Choose the most suitable chin prosthesis with your plastic surgeon.

How is chin implant genioplasty performed?

• General anesthesia.
• An average of 1 hour for chin implant genioplasty.
• Incision in the mouth if possible (invisible scar).
• Going home the day after chin implant genioplasty.
• Delivery of a card with the reference of the chin prosthesis fitted.

What is the post-operative course of a chin implant?

• Wear a small chin brace for 1 week.
• Follow-up visit with your plastic surgeon 7 to 10 days after the procedure.
• Absorbable threads used in chin implant genioplasty.
• 2 months off sport after chin implant genioplasty.
• Allow 5 to 7 days off work after chin implant surgery.
• Final result on retrogenia (receding chin) after 3/6 months
• Follow-up consultation to monitor the chin implant for one year, then every two years.