National report — Plastic surgery is increasingly popular among men, and chin augmentations are no exception to the trend. The American Society of Plastic Surgeons (ASPS) reports 9,583 men had the procedure in 2003, a sharp upswing from 5,622 procedures in 2002 and a slight gain over 9,561 procedures reported in 2001.
"There's a conception that a soft chin equals a soft personality," says Darrick Antell, M.D., a board-certified plastic surgeon, dentist and ASPS spokesperson. "Arnold Schwarzenegger, Brad Pitt — we can't imagine them without the chin."
Roughly 20 percent of all people — one-fifth of the general population — have a recessive chin, according to Massachusetts-based plastic surgeon and medical writer Dr. William Truswell. Leading-man chinImplants can give the broad-chinned look of a leading man, or get rid of the sagging "double chin" that tends to develop with age. (Because they lengthen the distance from the top of the chin to the thyroid cartilage where the neck starts, implants pull the skin more taut.)
As implants improve, surgeons may be able to increase the chin's vertical length in a couple years. (Photographs courtesy of Derrick Antell, M.D.)
In about two years, surgeons may even be able to increase the chin's vertical length. Implantech is expected to roll out a new product designed to achieve this effect, as opposed to the appearance of a wider or more jutting chin. That's a far cry from what doctors had to work with in the late '80s, when the typical implant was no more than an inch wide, and left patients with chins that were more pointed than prominent.
More and more patients are asking to have these antiquated implants removed, Dr. Antell reports.
While certain side effects, such as numbness in the area directly over the implant, are inevitable, chin augmentations have a relatively low complication rate. The creation of a "faux cleft" carries greater risks. Faux clefts require doctors to remove fat, muscle, soft tissue and even bone to create a dimple in the center of the chin. Such procedures run a much greater risk of disfigurement, but are rarely requested. Nevertheless, with even the more innocuous chin augmentation procedure, doctors should be aware of the risks and the safeguards against them. These risks include:
- Infection: Worried about the appearance of a scar, patients may initially consider having their implants inserted through an incision in the mouth. Surgeons consulted for this story unanimously agreed that the area just underneath the chin makes for a better point of entry. It's easier to maneuver and place the implant from this vantage point, and the absence of saliva makes the incision less prone to infection. Beverly Hills-based facial plastic surgeon Paul Nassif, M.D., says he has fixed nearly a dozen complications caused by incisions made through the mouth. Perioperative antibiotics, while not mandatory, can also help minimize infection.
- Misplacement: During surgery, it's crucial to make the subperiosteal pocket only slightly larger than the implant so that the implant fits snugly.
"If you feel the pocket's slightly larger, I sometimes put a dissolving stitch right in the midline and suture to the soft tissue so that it can't shift," says Dr. Antell.
Sizers can be used to determine the appropriate size implant — small, medium or large. Too small an implant could result in a "bee-stung" chin. Too large an implant can create a witch-like deformity.