1. What is Chin Augmentation?
2. What are the chin implants made from?
3. What does a typical Chin augmentation consultation entail?
4. How is Chin augmentation performed?
5. What are the different techniques in performing a Chin
augmentation?
6.What should I expect post-operatively?
7. When will the sutures be taken out and does this hurt?
8. Will there be scarring? If so where will the scars be
located?
9. Is there a lot of swelling involved with a chin
augmentation?
10. How long is the "down time" for this
procedure; how long should I expect to be out of work?
11. When will I be able to see the results?
12. What are the risks of chin augmentation?
13. What is Arnica montana or Bromelain, I have heard that
these homeopathics reduce swelling and bruising? Which is the best kind to
take?
14. How long do chin implants last?
Originally chin implants
were used for reconstruction for birth defects and trauma related
incidents. Now, they are being utilized to enhance a person's chin
or to create symmetry within the facial structure from a weak chin.
With a chin implant, the face is transformed into a more aesthetically
pleasing shape.
They are commonly made from hard
Silicone:
"As an implantable biomaterial it is
most commonly used in the form of the dimethylsiloxane polymer which is a
large molecule of repetitive units containing silicon, oxygen and methane,
((CH3)3SiO-[(CH3)2SiO]x-Si(CH3)3).
The extent of polymerization determines the
viscosity of dimethylsiloxane and hence its physical state: liquid, gel or
solid. Short, linear chains of polymethylsiloxane result in oils or gels. Heat
and catalysts increase branch length and form solids. Silicone polymers are
easily contaminated with heavy metals, low-chain-length polymers, and other
impurities during the manufacturing process and their refinement requires
specialized filtration and sterilization. Only Medical grade silicone is
approved for implantation in the human body." Grand Rounds - Advanced
Biomaterials
Although, many medical device
companies are manufacturing newer types which are made from expanded
polytetrafluoro- ethylen (ePTFE), rigid polyethylene, hydroxyapatite
(processed coral; HA). The rigid polyethylene implants are usually
screwed into place into the bones of the face to prevent shifting of the implant
post-operatively. The (ePTFE) implants are designed to be
porous so that the tissues can attach themselves to the implant to prevent
shifting.
There are also HA implants
- injectable pastes and carvable blocks, Mersilene mesh, PMMA, MMA, and
more. Please refer to the Chin Augmentation Options
Section to read of these materials. Discuss
with your doctor which implants he prefers and why.
First off, your doctor will
discuss your goals with you and he will explain what can be achieved
realistically. The usual goal of the typical patient is to
"correct" a lacking chin. Discuss with your surgeon the
goals and general result you would like to achieve. It is all individual.
Just like you!
Your doctor will take into
account your facial dimensions and natural face shape. There are not too
many types of chin implants but enough to go over with your surgeon.
The placement as well as the size of the chin implants will be determined by you
and your doctor. Don't be afraid to speak your mind during this time.
The Chin augmentation operation
is most frequently performed using Light Sleep Anesthesia or combined with other
procedures, General Anesthesia. Light Sleep Anesthesia is the use of
medicines to induce a state of relaxation and a light sleep. After your
arrival additional medications are given intravenously which induce a profound
state of relaxation. Patients usually sleep during the operation.
Much of the time patients have very little memory of the operation itself.
After this state is achieved then medicines are given to produce numbness of the
surgical area.
This procedure takes from 1 to 1
and 1/2 hours to perform. It may take longer if you choose to have
chin and cheek implants as well. Depending upon your facial
structure the incisions will be placed as inconspicuously as possible.
For chin implants the incision can either where the mouth gums and lip/facial
skin meet of under the chin. The risk of infection is higher if an
incision is placed within the mouth area. Although a strict post-operative
oral hygiene regimen can decrease this risk.
There may be surgeons who only
wish to use a certain implant type or a certain incision. surgeons would give
you a choice. As the updated techniques are less scarring than the
previous ones. The doctor may school an oral approach where the only
incisions are placed within the mouth area. No visible scar is made and
the oral incisions heal much faster. However, oral techniques
sometimes are plagued by a higher rate of infection. Especially in those
with problems with plaque build up or poor dental hygiene.
There is also a procedure called
a Genioplasty, also referred to as a "sliding genioplasty" or chin
advancement surgery. This surgery is the use of a bone saw to trim a piece off
the bottom of the chin and "sliding" it forward and then fastening it
with titanium screws. Metal plates may also be used as well. Although a
rarity, bone infection becomes a risk.
Additionally, there is the use of
injectable Hydroxyapatite (HA, processed coral) paste. It should be
performed over a course of a few months and the look is gradual and a long
process. Some surgeons inject a lot of it at once but be advised that this
is still a newer application for cosmetic reasons and reportedly the paste is
still "moldable" for a few days. There is no osteoinduction
(bone incorporation) as it is not porous but there are reports of absorption.
Check with your doctor on the
preferred technique that he utilizes. He may very well prefer the
traditional methods out of not being aware of the newer ones or he may very well
offer only the newer ones, with the thought that the older techniques are
"out of date". This subject varies with surgeon to surgeon.
Although, there is normally no
extensive pain related to chin implantation, pain medication is prescribed
beforehand. Your surgeon may also prescribe pharmaceutical grade Arnica
montana to reduce swelling and bruising. You may feel a degree of
numbness that should disappear within 1-3 months. You may continue to wear
a support brace while you sleep to allow your tissues and implant to heal in the
desired position and prevent shifting in the first few weeks,
Don't be alarmed at the presence
of bruising and swelling. The swelling will begin to disappear
within the first 5-7 days. Many patients return to work with the help of
camouflaging cosmetics at about 5 days post-op. The swelling resembles
inflammation of wisdom teeth or their removal and sometimes this excuse is used
at "the office". Although please realize that the swelling may
be apparent for months and the defined, chiseled look that you so desire may not
become evident for quite a while.
Things to be alarmed about that
are not normal:
- Temperature elevation greater
than 101 degrees
- Sudden swelling or sudden
discoloration
- Hemorrhage
- Increasing redness and
tenderness of the wound edges indicating infection
- Allergic reaction to drugs
- Shifting of the implant
The sutures, if any, will be
removed in approximately 3-5 days (sometimes 7-10). Your face will be
swollen for the first few days - this is normal. The removal should not
hurt extensively although your surgeon may feel the implant through your facial
tissues and this may hurt a little. The swelling should very much
dissipate after the first two weeks.
This depends on the incision
choice by you and your surgeon. It is quite possible to have either one of
these implants inserted with no visible scars whatsoever. Ask your doctor
if he is familiar with the oral incision location and what he thinks about it.
There will be some considerable
swelling associated with the trauma to the tissues. Especially if there
were screws involved. Bone trauma may hurt a little more than just tissue
trauma so take this into account when you decide on the technique.
Although, it is hardly enough pain to dissuade you from making an "incision
decision". Please go into this surgery well informed because many
re-operations or removals are due to patients not being able to handle the
swelling at first. It can be quite overwhelming at first.
You can expect to resume regular
activities in about 1-2 weeks. Although exercising should be be reserved
for after the third week. It really is individual but the swelling is
quite pronounced involving a facelift. There is bruising and of course a
support will be worn at night to alleviate tissue stress and to support the
healing tissues correctly. I wouldn't make any plans to attend any
weddings or other functions where you will be high profile for at least 4 weeks.
Most patients return to work within a week.
The results are immediate,
although you may think that the implant is too big at first glance. Give
your mind time to recognize the difference in swelling and augmentation.
Most patients are very satisfied with the augmentation results. Remember
this key: men sometimes think their chin after augmentation is too small where
women tend to think their chin post-operatively is too large and pronounced.
There is a chance of hematoma
(blood clots), seroma, numbness from nerve damage and hyperpigmentation
(permanent discolorations) caused by the bruising - although there is rarely
bruising with facial implants. There is the risk of implant shifting which
results in additional surgery to reposition the implant. There is the
chance of your disapproval which may result in a re-do or removal. There
is also a chance of asymmetry from tissues healing differently.
also known as: Mountain
Tobacco, Mountain Arnica, Common Arnica, Leopard's Bane and Sneezewort
plant family: Asteraceae
type: Herbaceous perennial
parts used: Roots and flowers
description: Arnica montana or Leopard's Bane is a perennial herb,
growing close to the ground. The leaves form a flat rosette, from the center of
which rises a flower stalk, 1 to 2 feet high, bearing orange-yellow flowers. The
rhizome is dark brown, cylindrical, usually curved, and bears brittle wiry
rootlets on the under surface.
habitat: Indigenous to Central Europe, in woods and mountain pastures,
although it has been found in England and Southern Scotland.
warning: This herb should NEVER be taken in raw form. This plant, like
many medicinal plants if ingested, can cause intestinal bleeding, abdominal
cramping and sickness. Homeopathy is the medicinal use of tinctures and
suspensions using herbs and other plants and should never be consumed without
proper preparation. Only respectable homeopathic remedies and tinctures should
be consumed.
Arnica montana has
been used in Europe for centuries to treat swelling, soreness and bruising.
This product is often misunderstood when confused with ingesting the arnica
plant in its raw form. When properly prepared, Arnica may significantly decrease
the healing time or the appearance of such. There are many formulations
from different companies. Sublingual (under the tongue) types are the most often
recommended for plastic surgery.
Please see our recovery
store for more information.
Bromelain
from the plant of the: Pineapple
also known as: Ananas, Nanas, Pina
plant family: Bromeliaceae
type: herbaceous
perennial
parts used: mostly in the stems of pineapples, but some fruit is used as
well.
description: 2 1/2 to 5 ft. high with a spread of 3 to 4 ft. The plant is
like a thick stem with a rosette of wide, waxy leaves. These pointed
green, red, and white/off white striped leaves are approximately 18 - 70 inches
long and graced with a spiny needle-like tip. The
plant produces a sweet to tangy and sometimes sour fruit that is yellow to white
in color. The unpeeled fruit is brownish with a hard, spiky covering and a large
green sprout from it crown. The fruit is shaped like a coffee can with rounded
ends and is about 10-12 inches long usually when considered prime and may even
weigh up to 10 lbs.
habitat: Indigenous
to southern Brazil and Paraguay, The fruit
is now grown all over in green houses and in the fields of Spain, Guatemala,
Hawaii and more. The pineapple is a tropical plant and thrives in hot, humid
places. Although it can survive cold snaps, it is not recommended for the more
northern areas if intended to be grown outdoors.
Bromelain is an anti-inflammatory formula
containing the proteolytic enzyme from the stems of pineapples.
Proteolytic enzymes are capable of dissolving proteins. It is most often used
after sports injuries, to relive edema and after surgical procedures to help
with swelling.
ALWAYS ASK YOUR SURGEON FIRST
BEFORE TAKING ANY MEDICATION.
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The silicone chin implants are
made to last your lifetime. Especially if the implants are the harder
variety and screwed into place, your risk of shifting is very minor.
Although anything having to do with inserting metal into bone run the risks of
infection and bone deterioration. however, most "bone screws" are
manufactured of titanium and just develop calcifications around the screws, if
that, and nothing more. Then again, everything is dependent upon the
individual and as you should know there is no "never" or
"definite" in medical science.
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This page was last updated: 07/25/2006
