Definition
Mentoplasty is the term for surgery that changes the shape of the chin to improve the appearance of a receding or overly prominent chin, creating better harmony of the facial features.
Brief Anatomy
Beauty and attractiveness are determined in a subjective manner and aesthetic features differ according to each individual’s unique preference. Nonetheless, there are certain profiles and contours that cause an individual to appear more or less attractive.
When speaking of an aesthetically acceptable profile, it can be said that the chin must be located within 2-3 millimeters behind an imaginary line that is drawn vertically, going from the base of the nose down to the front portion of the chin. A “weak chin” is a condition in which the chin is retropositioned greater than 2 to 3 millimeters. In women, a slight degree of retropositioning is acceptable and even desired aesthetically. However in men, a strong jaw line that gives a masculine appearance is preferred.
General Information on the procedure
Mentoplasty (chin surgery) is a term used to describe the restructuring and reformation of the “mentum” region of the face. Chin surgery add definition to the jaw line, improve overall balance of the face and restore loss of a clearly outlined profile.
In order to build up a weak jaw and augment a small or receded chin (also called chin augmentation), mentoplasty can be done by either adding an implant, or by moving part of the patient’s own chin forward (sliding genioplasty). In some selected patients with very small chin, the procedure may require the addition of some of the patients own bone (usually from the hip). In order to reduce a prominent, jutting jaw (also called chin reduction) mentoplasty can be done by removing part of the bone
Preop Preparation
Your first step should be to contact a surgeon to schedule an initial consultation. During the consultation, your surgeon will work with you to establish realistic expectations about the results of your mentoplasty procedure. The surgery will be explained in great detail so as not to leave any question or concern you have unaddressed. Depending on your needs and your surgeon’s observations, additional facial procedures may be recommended.
Your surgeon will also arrange to view your comprehensive medical history to decide if you are in satisfactory condition for chin surgery. Previous surgeries are also crucial to know about, as they can affect the risk of complications. Your surgeon may also ask for medical clearance from your general physician, and depending on your health, request laboratory testing. Pre-operative planning may require special x-rays to determine the amount of augmentation, projection, recession, change in height or position required to improve the appearance of the chin.
In the weeks leading up to your mentoplasty operation, it is important to cut down, if not eliminate, smoking and drinking alcohol. Surgeon must be informed about any medications that affect bleeding (such as coumadin or warfarin). Aspirin, any medications containing aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs, gingko biloba, ginseng and vitamin E supplements should be avoided in the weeks leading up to the surgery. Lastly, daily medicines must be continued as long as they have been approved by your surgeon.
You may not eat or drink after midnight the evening before the procedure unless instructed otherwise. Before the procedure, make sure to brush your teeth.
Operation
It is a relatively simple operation for the surgeon and for the patient as well. Mentoplasty procedures may be completed under local anesthesia, with or without mild sedation, or under general anesthesia. The procedure may be performed in an out-patient facility, in the office, or hospital. Depending on the technique, the mentoplasty procedure can last between 30 minutes and 3 hours.
If a chin implant is required, the surgeon begins the procedure by making a small incision under the chin or inside the mouth. Incision placement should be discussed with your doctor before surgery. After the incision, the surgeon stretches the tissue to allow for implant insertion. Regardless of which implant is chosen, the implant is carefully placed in front of the mandible, deep into the chin’s soft tissue. Each individual’s unique set of circumstances and unique anatomy dictate the implant requirements.
Generally no screws or plates are required for mentoplasty. The implant is held in place with a suture or it is placed beneath the periosteum, which is the fibrous protective layer adherent to the jawbone. If the chin size is being reduced, the surgeon, after making a similar incision, sculpts the bone of the chin to achieve the desired decrease in projection and alteration of the contour to change the appearance.
There are a number of chin implants that achieve adequate chin resculpturing. Gortex and silicone are two of the most common implants as they have proven to achieve optimum recontouring in many studies.
Post Op Instructions
It’s common for patients to experience some tenderness after mentoplasty which can be controlled with prescription of pain medications. Patients may also experience a stretched, tight sensation which typically subsides within a week. Swelling and bruising is also likely to occur. Swelling generally reaches maximum and begins to subside 1 week after the operation. The chin dressing is generally kept in place for two or three days following surgery. The stitches are usually removed or dissolve on their own within about five to seven days after mentoplasty.
Immediately after surgery, chewing may be limited and following a liquid and soft food diet may be necessary during the first few days. Patients are typically able to return to work and other normal activities within about ten days after surgery. Patients are advised to avoid strenuous activities for the first few weeks after surgery. In addition, activities which can bump the face should be avoided for about six weeks.