mentoplasty or chin filler

Cosmetic chin surgery
Mentoplasty is intended to correct a weak chin in man or a large and squared jaw in the women that are considered rather serious aesthetic defects considering a face profile. Basically it can be said that there is a direct relation between the correct proportions of the chin, maxilla and lower jaw with an attractive face.
Several scientific studies have shown that the chin is subconsciously associated with male virility and grace and sophistication in women. A disproportion of the chin gives the face a caricatured appearance, so much so that in satirical cartoons the roughness is associated with the prominent jaw, as well as a weakness to the weak chin.
These aesthetic defects can be corrected by Mentoplasty, which allows to rebalance face and harmonize its proportions.
Cosmetic defects
The mentoplasty is a surgical procedure that corrects the defects of position of the chin relatively to the rest of the face.
In cases of protruding chin, excessively disproportionate, very prominent (prognathism) or “like a witch”, a reductive Mentoplasty is performed.
The excessive protrusion of the mandibular bone is corrected through an incision inside the mouth, under the gums, and by sectioning in a “ stair pattern” the bone is pushed back and fixed by plate and wires .
When the chin is disproportionate in defect, very short or too blunt, an additive mentoplasty is made to the contrary. In some cases, we proceed with the insertion of an alloplastic implant made of stiff silicon that increases the projection of the chin
In other cases, genioplasty is used, a procedure which involves a horizontal osteotomy to the median welding of the two halves of the jaw and their subsequent repositioning, which is performed with the help of a maxillofacial surgeon.
Other defects may concern a chin that is too angular, asymmetric, with a pointed shape, with the presence of a dimple too deep (considered a defect especially for a woman) or the so-called “double chin”. In these cases it is possible to correct by using a filler with a high G-prima that means that has high cohesivity so to be able to push the skin over the bone. This is called Liquid mentoplasty by filler that is mostly used instedo of a alloplastic augmentation implant with an immediate result. In other cases it is possible to improve volume and get rid of slight jaw skin laxity using fat transfer.

When an unpleasant defect is fatty deposit under the chin even in young and with elastic skin, we talk of the “double chin” deformity. A less invasive treatment is done by injecting subcutaneously a medication called Belkyra or Kybella made of a solution of desoxycolic acid that dissolves the fat stored over platysma muscle. This treatment can be repeated after 2 months, give a 2-3 days of swelling and local numbness but is really effective. Another way to solve it is by direct liposuction of fatty deposits by small cannula and subsequent compression bandage.
In more severe cases we proceed with the cervical face lift that guarantees the contextual result of tightening and definition on the neck and face profile.
It may often be appropriate to thing a holistic procedure to a face profile, an integrated surgical approach that balances the lateral vision of the face overall, in the logic of maximum harmony between forhead, the chin, lips and nose and that is when we talk about a PROFILOPLASTY. This type of plastic surgery is also required by transgender patients because since the size and shape of the chin has significant differences between males and females.
Functional disorders
Chin malformations may be due to trauma (for example a road accident) or tumor pathology or even a disorder of the jaw bones that continue to grow on one side of the face but not on the other, resulting in facial asymmetry. Another case is the total absence of a piece of the mandible (known as congenital agenesis).
In the presence of such functional defects, particularly due to the resulting chewing problems, Dr. Tommaso Savoia proposes an operation in collaboration with a maxillofacial surgeon, to correct, together with the aesthetics of the profile, also an impaired dental occlusion. Often the development of the chin has been impaired by a narrow palate connected to childhood pathologies of the upper airways (tonsillitis, adenoiditis), which forced them to breathe through their mouth. Even though facing functional problems, Mentoplasty is yet reserved to adult patients. For children you must at least wait that all permanent teeth are grown.
Bruxism( Grinding) and botox to improve jawline.
Jaw contour may appear squared in patients who suffers of teeth grinding and it is often seen in Asian patients. These patients tend to grind and clench during night and awake in the mornig often with muscle-tension head pain and mouth locked. This continuous movement of the teeth causes a muscolar hypertrophy of Masseter muscle that extends at the corner of the jaw so to determine a squared aspect of the face. The ideal treatment is a bite appliance prescribed by dentist but many patients don’t use it correctly every night. That is why an extraordinary treatment is to inject botulinum toxin into the masseter muscle so to weaken and give a relapse of these symptoms early as 7 days. As an addiction result the muscle appears to have lost some bulkiness giving a more fine jaw contour and a more vertical slim face profile.
Botox can be used also to treat orange skin of the chin or to improve neck appearance relaxing platysma bands by the so called Nefertiti neck lift.

Specialist visit and mentoplasty by filler

According to Dr. Tommaso Savoia it is essential to study the type of intervention based on the individual patient, through a deep knowledge of the physiology of that complex architecture of muscles that give uniqueness to the expressions of an individual’s face. “The face is the mirror of the soul”, is not a clichè, but it inspires the surgeon’s need for a frank debate with the patient in search of workable solutions and maximum personalization of the result in its facial appearance.
The approach of the first visit is that of a complete anamnesis that evaluates the patient’s profile, his frontal appearance and all the visual angles of the face; not only the chin, but also the nose and other anthropometric evaluations should be valued in search of a perfect harmony.
In some cases for patients who want to experience a non permanent change or just are keen to see a simulation of their surgical result, a Chin filler is the first choice according to dr Savoia. A high density filler like Voluma, Volux or Radiesse are placed over the chin bone to pump forward the chin skin and get a result that can last up to 15 months.
Preparation for intervention
Before resorting to chin surgery, the patient must stop all medications containing aspirin or NSAIDs and stop smoking.
In the event of an external incision under the chin, the patient must use an antibacterial face cleanser. In the case of an intraoral approach, dr. Savoia will prescribe a specific mouthwash.
It will also be necessary for the patient to carry out some standard examinations: blood counting formula leukocyte, blood glucose, creatinine, blood urea, plasmatic electrolytes (chlorine, calcium, potassium, sodium), total proteins, liver function (ast, alt), coagulation (pat, PTT). In addition, an electrocardiogram must be performed.
Surgery
Chin augmentation is achieved by making an incision inside the mouth (intraoral) from canine to canine into the lower part of the gums. Dr. Tommaso Savoia then proceeds to insert a small rigid silicone prosthesis, placed over the bone on the lower part of the chin .
The duration of additive mentoplasty surgery ranges from a minimum of 30 minutes to a maximum of three hours (in case of integration with orthognatic or maxillofacial intervention). Except for this exception, hospitalisation lasts only one night at the clinic or day hospital. The operation is under local anesthesia with sedation.
Post-operative recovery
Chin augmentation: after surgery, a compressive bandage should be used for 3 to 4 days over the chin skin. The stitches will absorb spontaneously and the patient will have to undergo antibiotic therapy at home and oral mouthwash applications several times a day, in order to prevent the risk of local infections. In case of insertion of the prosthesis from the mouth, the scar will remain hidden inside, while in the case of external way, a small scar hidden under the chin will remain.
The risks of the surgery are related to the possible poor positioning of the prosthesis and its displacement. There is also a risk of wound infection in cases where the prosthesis is inserted from the mouth: this risk is controlled by post-operative antibiotic therapy and the use of oral antiseptic mouth wash. During the first few days after surgery, you may feel stinging or pulsating pain in the chin area, generally controllable with common analgesics and anti-inflammatories, and will recede in a few days. If has been made an intraoral incision, a modest bleeding from the mouth in the first 48 hours is predictable and normal.
If a submental approach has been practised, the dressing must be maintained during the first week and avoid excessive jaw movement.
Under normal conditions, swelling and ecchymosis after surgery will subside down significantly in a few weeks. The final result, on the other hand, cannot be appreciated until at least 6 months have passed since the intervention.
Price
The cost of a chin surgery is extremely variable and depends on the type of surgery (reduction or augmentation mentoplasty, Genioplasty, Profiloplasty) and other parameters that will be clarified by the doctor during the specialist visit.
The average prices are:
500€ for a soft filler
1500€ for lipofilling of the chin
4000€ for chin implant