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Chin-Jowl Implants Better than Chin Only

Posted on: June 13th, 2004 by California Skin Institute

Spokane, Wash. — Combined chin-jowl implants give a better, longer-lasting cosmetic result than central chin implants alone, Greg S. Morganroth, M.D., said at the annual Pacific Northwest Dermatological Conference.*

Central chin implants provide only frontal projection and can shift over time.* The chin-jowl implants, on the other hand, are anchored laterally and are better retained.* They can improve the appearance of the anterior mandibular groove (also called the prejowl sulcus) and can be sculpted to help restore facial symmetry in patients with hemifacial atrophy.*

“This procedure can be performed solo, or it can be integrated into your neck lipo,” said Dr. Morganroth, a dermatologic surgeon in private practice in Mountain View, Calif. “It can be integrated into your facelifts.* It makes a huge difference because part of that great facial result is having that nice, sharp jawline.”*

When combined with a “facial lipolift” (which includes neck and jowl liposuction, a laser peel, and a short-scar facelift), implants can rival the results of a traditional surgical facelift.* Unlike a traditional facelift, however, the full implant procedure can be performed in 2-3 hours under local anesthesia and allows patients to return to work in a week.*

Any patient whose recessed chin is less than 2 cm behind his or her forehead is a candidate for a chin-jowl implant.* Patients whose chins are more than 2 cm behind the forehead will more likely require maxillofacial surgery to bring the jaw forward.*

The procedure is relatively simple, Dr. Morganroth said at the conference, sponsored by the Washington State Dermatology Association.* It requires the same instrument pack a dermatologist would use for the excision of a basal cell carcinoma, with the addition of a Freer elevator.* For anesthesia, he performs a mental nerve block followed by five or six injections of 1% lidocaine with 1:100,000 epinephrine into the periosteum along the chin.*

The surgery starts with a 1.5- to 2-cm submental incision down to the periosteum that is elevated to allow the creation of pockets on the right and left sides of the mandible.* These pockets must extend at least 5.3 cm laterally and must be slightly larger than the implant.*

The surgeon then positions the implant along the mandible, checking for symmetrical placement.* One or two sutures anchor the central part of the implant to the underlying periosteum so the implant won’t shift upward.* All that remains then is to suture the periosteal, muscular, subcutaneous, and skin layers.*

Dr. Morganroth said that in his hands the procedure is very safe, although all patients experience temporary bruising and swelling.* Other potential complications include bone resorption under the implant, slurred speech from swelling in the mentalis muscle, infection, hematoma, and injury to the mental nerve or the marginal mandibular nerve.* Asymmetry is also a possibility, as are migration of the implant, hypertrophic scarring, and an overcorrected appearance.*

By Robert Finn

*Individual results may vary and are not guaranteed.