Chin augmentation is the use of synthetics or
biologicals to augment, or make the mentum/menton (the lower portion
of the face lying below the lower lip and including the prominence of
the lower jaw -- called also chin) bone structure of the face more
prominent. It can give balance to an otherwise less defined face or
further augment an already existent chin structure. The fleshy pad of
the chin is normally from 8 to 11mm thick.Postoperative instructions regarding activity, medications and
office visits will be given following your surgery.
Depending upon the amount of augmentation and the technique
or material used (if applicable), chin augmentation can last about 30
minutes hour to 1 1/2 hours -- depending. Possibly more if sliding
genioplasty, reconstruction, revision surgery or additional
procedures are performed.
First, you will be monitored so that the surgical team can properly
monitor your vital statistics before, during and after your
operation. Prior the procedure you will be given a pill for sedation.
Once you are on the operating room table, you will then be given
local anesthesia. The anesthesiologist will more than likely insert
an IV for a saline drip to keep you hydrated and have a vascular
"doorway" for anesthesia, antibiotics, and other medications.
This is usually done before you get into the actual O.R. - by a nurse
- and you have a saline bag hooked up to you. The medications will
usually be given with a drip system with this saline. As said before,
the saline will keep you hydrated both during and
post-operatively. The anesthesiologist or surgeon will then
determine if you are sedated properly, your stats are stable and if
you are ready for the surgery to begin.
Then, an injection of local anesthetic into the menton nerve cluster
usually by way an intraoral injection. This will "numb" the lower
half of the face so that you do not feel any pain.
You will be injected with a solution of Lidocaine, epinephrine and
saline, or an epinephrine/bicarbonate/lidocaine mixture. The
epinephrine is a vasoconstrictor. This will impede your skin's
ability to bleed excessively.
The incision will be made in the predetermined placement, the implant
(if applicable) situated directly on top of the bone and either
sutured into it's pocket or screwed into place. I may remove and
replace the implant several times intra-operatively to ascertain a
custom fit before permanent fixation.
For sliding genioplasty:
A sliver or section of bone is sawn off and "slid" forward. The bone
graft is then secured into its new place with bone plates and screws.
The surgical team then performs a sponge and instrument count and
your surgeon then closes your incision with, more than likely, a
non-dissolvable type suture.
Sometimes percutaneous sutures are used but only very rarely with
chin augmentation. This is normally reserved for malar
implants. This is where the sutures stick partially out of the skin
and can be removed later on by tugging gently on them after they have
partially dissolved within. They can also be sutured with
dissolvable stitches inside the surrounding tissues. Even still,
they may not be sutured at all, relying on your body's collagen to
secure into place. If no internal sutures are used you will more
than likely wear your tape or a head wrapping longer unless the
pocket specifically fits your implant snugly.
This wrapping will be worn post-operatively during the day for the
recovery period and is worn at night to help it heal properly in the
face per your surgeon's instructions. Some patients will have a
pressure dressing placed around your head such as you would see in a
face lift patient or a neck liposuction patient. If you are not
familiar with this "look" it involves wrapping a dressing around the
top of your head to underneath your chin, sometimes slightly over your ears.
Of course there may be differences in surgical technique depending
upon the preference of your surgeon.You are then gently awakened and
brought into the recovery room where the recovery nurse will monitor
your vital stats until you are ready to be released.
This is dependent upon the individual but may take up to one
hour. Your face may feel tight and quite tender as the anesthesia
wears off. You may even feel emotional or upset - this will depend
upon your body's reaction to anesthesia. You may also experience
"rigors" or shivering. This may feel uncontrollable and is usually
from the medications. The recovery nurse usually has wrapped you in
a warm blanket but if not, request one. It certainly makes things
Your prescribed medication should alleviate this pain and
discomfort. However, if you believe your pain to be out of the
ordinary once you get home, call me or the on call staff
immediately. You will be driven home by your spouse, significant
other or friend as you will not be able to see, much less drive yourself home.
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