Should I Get a Chin Implant with Rhinoplasty?

There’s a reason why a rhinoplasty is one of the most popular cosmetic treatments today. Your nose is a central defining feature of your face, and if you are bothered by the way your nose looks, a rhinoplasty can improve your appearance. But many people aren’t aware of how their chin looks and often overlook the chin. I was a facial plastic surgeon during my time in the Air Force and rhinoplasty was the number one surgical procedure I performed.

There were many patients who could have benefited from a chin implant procedure, but they and I rarely brought this up. The reason is Air Force patients undergoing rhinoplasties generally are doing it for reconstructive purposes. A chin implant to enhance their appearance is cosmetic and they have to pay for any cosmetic procedures.

There is increased interest in the chin, and I’m seeing many rhinoplasty patients asking if a chin implant is needed. With all things cosmetic, I don’t like the word “need.” Everyone is different. But you are right when you ask if chin implant is needed. First, you should realize that—while your nose is a key central defining feature of your appearance—your chin’s structure also plays a complimentary role in your overall attractiveness.

Evaluating the Chin

A strong chin balances your nose and face. An important guideline I use is to examine how far your chin projects. If you draw an imaginary vertical line from your lower lip down to the floor, the front of your chin should ideally be right at the line. If you are male, your chin should be at or even in front of this line. If you are female, your chin’s front edge can even be a little bit (a few millimeters) behind the line.

Since you are focused on the rhinoplasty, we typically focus the majority of the examination and consultation on your nose, its features, and what options exist to improve your nose. Only after that is completed and you are satisfied with the discussion do we go on to determine if your overall results can be enhanced with a chin implant. The evaluation is fairly straightforward. If your chin is weak, then I will point out that a chin implant will improve your overall attractiveness, by enhancing your overall facial balance.

I think everyone finds a strong jaw attractive. Very rarely does someone come in with an oversized jaw (think Jay Leno). That’s a bit more difficult to fix, since bony reduction surgery has to be done. That can cause significant swelling. Anytime you have to cut your jaw bone, the risks increase—particularly the potential for disappointment due to possible irregularities of the new chin.

Fortunately, I’ve found that over 90% of patients with chin complaints have a weak chin that is easily addressed with a chin implant. If you decide that a chin implant will improve your results, then it’s best to place an implant at the time of the rhinoplasty.

I like to perform rhinoplasties under general anesthesia. I don’t like to do surgery on a key part of your airway if you are sedated and unable to control your movements. I find most surgeons today perform their nose surgeries under general. There’s no hard and fast rule in which order you need to do the surgeries. I prefer to do the rhinoplasty first since that’s the most complicated surgery.

Chin Implant Process

After the rhinoplasty is done, then I perform the chin implant. I use an external incision, and create a precise pocket for the implant. We usually go over various chin implant options at the preoperative visit and decide on the best choice. After the implant is secure and in good position, then I will sometime secure the implant to the periosteum using vicryl suture(s).

Then the wound is closed in layers. Some surgeons place chin implants via an intraoral incision. The advantage is you don’t have an external scar. But the main disadvantage is less precise pocket, in my opinion. I believe it’s much more important that you have an excellent result. That means getting an implant that looks as symmetric as possible.

The external scar is really hard to see, and, in my opinion, not a major reason to discount an external approach. After surgery, your recovery will not be too bad. There may be some soreness and pressure around the nose and chin, but almost everyone tolerates these fine and don’t need much narcotics (if any). You can expect the implant to be pretty secure by 10-14 days.

For more information about rhinoplasties and chin implants, schedule a consultation with Dr. Yu or please contact our Concierge Patient Coordinator at (210) 876-6868.