The chin is an important area in facial aesthetics which is located at the bottom of the face. It is one of the basic structures that determine the shape of the face whisch is either round or angular and one of the main structures that determine the morphology of the face. Although it is not in the first place in the list of applications made in facial aesthetics, a right sized, shaped and contoured chin has importantance for a balanced and harmonious face. Strong chin in men and elegant chin in women are preferred.
The morphological structure of the upper and lower jaws and their harmony with each other are important in terms of functionality as well as aesthetics. If the upper and lower jaws are not correct for biting, they should be corrected with orthodontics and orthognathic surgery. To do this, the treatment is planned by performing cephalometric analyzes. There may be size, smallness or a fault at the tip of the jaw without such a problem In recent years, the demands for changes in the chin have increased as the concept of strong chin or elegant chin has been included in aesthetic surgery procedures,
In this article, we will talk about the intervention to the chin tip.
The chin tip is wider in men and gives a more oblique appearance. It gives two refractions of light when viewed from the front. It refers to the strong chin.
In women, the chin looks more triangular and gives a single light refraction.
The chin tip is evaluated as large or small by considering both the bone structure and the soft tissue. It is also decided by proportioning with the facial skeleton. Lip size should be considered in cases such as face height.
There are benchmarks for deciding chin size.
- 1. Labiomental fold: It is the fold between the lower lip and the chin. In men, with the upper lip of the lower lip. The distance between these folds is 4 mm on average and 6 mm in women. The deeper the pit is, the longer the chin is compared to the lip.
- 2. Chin lip line; The most protruding point of the lower and upper lips and the tip of the chin should be in the same direction.
- 3. Chin-neck relationship: The angle between the chin and the neck should be between 105-120 degrees.
- 4. Nose-chin-lip relationship: The chin should be 3 mm behind the line passing from the nose to the lip.
At the end of all evaluations, it is decided how to intervene in the jaw. Sometimes, nose, neck and lip surgeries can be added to the jaw tip surgery for instance a person with a large chin can only solve the problem with rhinoplasty.
Chin Reduction Surgery
This type of surgery can be planned with two different methods.
- 1-Rasping (Filing) It is usually done with small incisions made inside the mouth. The bone is reached through the mouth and the bone is filed with the help of rasps. This rasping process is done until the bone reaches the desired size and then it is closed with pressure since there may be minor bleeding in the area. The opening in the mouth is closed with absorbable sutures. Therefore, there is no need to remove the stitches. After this procedure, there may be swelling in the bone for 1-2 weeks, it is appropriate to put ice afterwards to prevent this. There is not minor pain and painkillers can be taken if it occurs.
- 2 -Bone Excision is the he process of removing excess bone in the chin area.The operation is started by making small incisions inside the mouth or under the chin. The part of the bone that is excessive according to the measurements is marked. Then, this excess piece of bone is cut and removed with the help of appropriate surgical instruments. Then the sharp ends of the bone are filed. After the surgery it is appropriate to apply ice for a week and use painkillers.
Chin Augmentation Surgery
Chin augmentation surgeries are performed more than chin reduction surgeries. Small jaws distort at the rate of ¼ of the face. If there is no problem with the teeth and there is no chewing problem, it may be sufficient to enlarge the jaw tip only. Adjusting the size from the chin tip is usually done according to the nose and lip line. There are several methods for chin augmentation surgery.
1. Bone advancement surgery:
It is an operation performed with incisions through the mouth or under the chin. When the bone tissue is reached, then the tip of jaw is cut. The bone is shifted forward according to the way its calculated and then its new location is determined with surgical plate and screws. Although there is no serious pain after the surgery, painkillers should be used. Swelling may occur in the chin area for several weeks and for this, ice and steroids are used. Bone fusion usually occurs within three weeks. If desired, the plates and screws placed after six months can be removed. However, there is no harm in keeping these plate screws on the steel. Sometimes this surgery can be combined with rhinoplasty surgery.
2. Chin augmentation of the with fillers;
During the augmentation two types of fillers are used. The first of these is the patient's own fat tissue. Fat is removed by liposuction and the desired amount is placed on the chin and it does not cause any allergies and in most cases no infection which is an advantage. But the downside is that it is not permanent as the body absorbes it within six months to two years. The second type of filler is hyaluronic acid. It is prepared in special tubes and easy to apply. However, this filler is also absorbed and at the same time there is a risk of allergy.
3. Chin augmentation with implants;
during the surgery two types of implants are used; the first of these are silicone implants which are different in sizes and intraoral or it can be placed under the chin and it is necessary to fix it with screws to keep it fixed where it is placed. There is a risk of osteoporosis in the long term, it usually does not cause allergies, but there may be a risk of infection in the early period after the surgery.The second type of implant is biocompatible materials, these are the products containing porous structure to the bone. There are different sizes and types and surgery is done under local or general anesthesia, they are placed inside the mouth or under the chin. It may be necessary to fix it with screws as well as with its own nails. Although they are biologically compatible, there may be some infection and allergic reactions both in the early and late periods and if that is the case it is necessary to remove them.
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