How its done

Chin augmentation is a popular operation to provide increased definition of chin. A strong chin gives a sense of strength and character. Mr Golchin carries out chin surgery by making incision inside the mouth between the teeth and the lip. The incision measures approximately 2 cm in length and usually heals so well that even a dentist may not see it during routine dental care.

The augmentation is carried out either on the bone of the chin or over the layer of connective tissue, which sits on the bone. In either case it is very deep indeed. The augmentation is not carried out within the skin. Consequently the skin can be moved over the area and once it heals it feels like a normal chin.

The procedure requires dissection through the incision to expose the area of the chin bone. The area of augmentation is planned carefully to determine the level of protrusion and width and exact position. These areas over the chin are elevated to allow the augmentation to take place.

Many materials can be used for chin augmentation ranging from natural materials of the patient's own body or a prosthesis. Mr Golchin prefers the silastic prosthesis as it is very flexible, permits easier introduction through a smaller hole and easier removed. Mr Golchin has not had problems with infection and extrusion of chin augmentation prosthesis and finds it an extremely reliable and satisfying operation.

There is usually swelling, limitation of lip movement and special care for the diet in the week following this surgery. Most people find the swelling will settle over a period of weeks, perhaps months.

Cheek augmentation is carried out in order to provide greater definition of the cheekbones. Cheekbones are solid and therefore solid augmentation is ideal here. Solid cheekbones provide a foundation for the eyes and are regarded as a sign of strength.
Access for this procedure is carried out inside the upper lip on the cheekbones. This section is carried out over the bone to create a pocket for the cheek materials to sit. The materials are inserted on each side, held in place and the area is closed.

Cheekbone augmentation requires careful planning and marking and measurement in order to ensure that the outcome fits the planned changes. Mr Golchin prefers to use silastic materials, as these materials can be folded to insert through a very small pocket into the field. This reduces the risk of any possible rejection and infection.

RISKS

Injury to the sensation of the lower lip is a potential complication, although one Mr Golchin has never seen. Further, asymmetry and difficulty in obtaining exact sizing is a risk, although very rare indeed with good technique. Adding 1 cm projection chin prosthesis will not always provide 1 cm of increased projection. In some cases a tissue reaction around the prosthesis provides a little extra augmentation and in some cases stretching of the skin and soft tissue over the chin prosthesis will thin the skin a little resulting in less than 1 cm protrusion. Nevertheless, these minute changes usually do not hamper the overall effect, which is planned and measured before surgery.

Other approaches have been used to chin augmentation by making incisions on the outside and fracturing the actual jawbone. Mr Golchin prefers to avoid any possible noticeable external incision for obvious reasons so that the patient has no obvious signs of having had surgery. Furthermore, the external incision does suffer the risk of puckering and irregularity aggravating the whole problem.

All patients have some facial asymmetry and this will always be evident after cheek augmentation, as it existed before. The level of asymmetry is usually very mild indeed but is always more noticeable when looking for it.
Apart from asymmetry mentioned above, risks include damage to nerves of movement or sensation around the cheek and lip. This is very rare indeed. Other problems might be infection or rejection of the materials and bleeding, again all of which are very rare.