Facial Implants Overview

A lot of what we perceive to be a beautiful face is due to its proportions and symmetry. If nature did not give you a nice chin, a good jaw line, or beautiful cheekbones, cosmetic medicine can. All of these features can be achieved through the use of facial plastic surgery with facial implants, which includes chin augmentation, cheek augmentation, and jaw augmentation. Implants can also be used to repair a face damaged by birth defect, trauma, or disease.

Many people go to a plastic surgeon thinking that their nose is too prominent or sticks out and are then told that the problem is not their nose (or not just their nose) but a chin that is too weak or cheekbones that are barely there. Making the chin, cheeks or jaw more prominent can bring the entire face into harmony.

The most common type of implant used in facial surgery is made of a solid, flexible silicone. These implants come in many shapes and sizes and can even be carved to create a custom implant. Other implant materials include expanded polytetrafluoroethylene (ePTFE or Gore-Tex) and hydroxy apatite.

With all facial implants, the surgeon must create a space called a pocket to contain the implant. Solid implants are then inserted into this pocket and may or may not be screwed into the underlying bone using surgical screws.

For solid chin implants, the implant can be inserted through an incision made either in the mouth between the lower teeth and lip or under the chin. Jaw implants can be inserted through incisions in the mouth or under the chin. Cheek implants can be inserted either through incisions made in the mouth, incisions made on the inside of the lower eyelid, or incisions hidden in the hairline at the sides of the face. Solid facial implants can also be inserted through incisions made for other types of facial plastic surgery, such as a face lift.

The body normally forms scar tissue around the implant and this can actually make it easier to remove an implant if a problem occurs. However, some types of solid implants are made of porous material that the scar tissue grows into. These are more difficult to remove.

The chin, cheek and jaw areas can also be augmented with injectable fillers, a procedure that is considered minimally invasive. Here, the plastic surgeon injects materials such as collagen, hyaluronic acid (Restylane and other brands), or other products to build up the chin, cheeks, or jaw area. Fat grafting is one type of this procedure, where the filler being used is fat harvested from elsewhere on your body that has been refined and is then injected into the area being augmented.

Another form of chin augmentation is sliding genioplasty. This is a surgery in which the surgeon makes cuts in the lower jawbone (the mandible) and frees a piece of bone. This piece is then slid forward and screwed into place on the jawbone, making the chin more prominent.

Facial implant surgery can be performed by a plastic surgeon or by a maxillofacial surgeon. Some maxillofacial surgeons are dentists, some are doctors, and some have both dental and medical degrees.

Implant surgery usually takes 1 to 3 hours. It can be performed under local anesthesia with some sedation or under general anesthesia and can be done in a special surgical suite in a doctor's office. It is often combined with other procedures such as a nose job or face lift. Usually, the patient goes home a few hours after facial implant surgery is completed.

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