Mentoplasty (chin enlargement)
Chin enlargements can be done by either placing an implant over the chin or cutting the bone and moving it forward. It is kept in its new position by either wires or plates and screws. Advocates of advancing the bone feel that there is less chance of infection because a large foreign body (the implant) is not used. However, when plates and screws are used to maintain the new position of the chin, these are foreign materials as well. Placing an implant is much simpler, less traumatic and allows the surgeon the opportunity of carving the implant to customize individual needs. The incision can be made under the chin or inside the mouth. The two most popular implants are either a firm silicone implant or a porous polyethylene implant. Although the silicone implant is easier to put in, it is never incorporated by the body and, therefore, always moves around a little. Also, over time, the silicone implant causes the bone underneath it to resorb, making the chin less prominent over time. For these reasons I prefer to use the porous polyethylene (Porex) implants. Once in place, the tissues grow into it and make it stable. Bone underneath does not resorb. I can carve it to meet each patient’s individual needs. The silicone implants are not usually carvable. Although infection is a potential complication, it is very rare and I have not had that happen in any of my patients as yet. Most patients have been thrilled with the results.