CHIN SURGERY - MENTOPLASTY

Chin surgery is one of the most common of all facial surgical procedures, with permanent and satisfactory results.  Chin implants add definition to the jaw line and improve overall balance of the face.

The mandible, “jawbone“ , or inferior maxillary bone forms the lower jaw and holds the lower teeth in place.   The jaw adds proportion to the chin and provides balance to other facial features.  A weak or receding chin can be corrected through a chin implant, simultaneously to with rhinoplasty and on an outpatient basis. 

Chin augmentation is performed by making a small incision either inside the mouth where the lower lip joins the teeth, so that there will be no visible scarring, (the preferred location), or in the small crease line under the chin.  The chin implant is then inserted and positioned in front of the jawbone.

The surgeon then checks its appearance for proper balance and may adjust or modify the implant to ensure the proper look is achieved.  Many chin augmentations are done in conjunction with rhinoplasty.  

FREQUENTLY ASKED QUESTIONS

¿Am I a candidate for chin augmentation?

Sometimes people want to change something about their face, but they do not know exactly what part of it. Many people, who see a facial plastic surgeon to ask about a nose surgery, or an eyelid surgery, actually find out that part of their problem is a weak chin. It is just through a computer imaging study that patients may understand how a chin implant can change the proportion and balance of the face.Chin augmentation is one of the facial surgical procedures that contributes more to restore balance and a younger appearance.

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Your understanding of instructions is essential to a successful final result. Dr. Espinosa accurately analyzes the face before surgery. Through a computer imaging study, Dr. Espinosa examines your bone structure and facial features, in order to make the proper surgical decisions. In the same way, he may evaluate your general state of health, order some lab testing, and x-ray studies, as well as he may also recommend you visit your orthodontist before surgery.

¿How a Mentoplasty is performed?

Mentoplasty is performed by making a small incision inside the mouth where the lower lip joins the teeth. The chin implant is then inserted and positioned in front of the jawbone. Because suture (stitches) material is usually of a reabsorbable nature, suture removal is unnecessary. Chin augmentation is also performed by making a small incision under the chin. Depending on your needs, the facial surgeon will decide which is the best surgical technique to perform. In more complex cases, time is needed to allow your jawbone to grow through mechanical procedures.

¿What kind of anesthesia will be used during the surgery?

Usually sedation and a local anesthetic medication are administered in the operating room, during a mentoplasty. When mentoplasty is performed in conjunction with other procedures, general anesthesia might be necessary. Most chin augmentations are performed under general anesthesia or light sleep sedation, where you are lightly asleep and entirely unaware of the surgery. Both types of anesthesia are secure, you do not feel anything during surgery and you wake up quickly and comfortably, feeling no pain and experiencing no anxiousness. You will be carefully monitored by your anesthesiologist during and after surgery. Anesthesia can be a reason for preoperative anxiety. However, pre-operative routines make it possible to perform safer surgical procedures. In the first visit, Dr. Espinosa may order some lab testing to evaluate your general state of health, in order to take precautions and avoid any complication with anesthesia. Subsequently, a pre-anesthetic evaluation will be ordered to determine the appropriate anesthetic plan. On the day of your surgery, your health history will be reviewed by Dr. Espinosa, the anesthesiologist and the nursing staff to ensure a safe and uncomplicated experience. Your vital signs will be carefully monitored by the anesthesiologist during and after surgery. He will treat any possible medical problem which you may develop during surgery. You will be under your anesthesiologist's supervision until surgery is completed and during your recovery phase. Because anesthesia affects your entire system, it is important for your anesthesiologist to know as much as possible about you. Please inform him about your allergies, medications and past anesthetic experiences. Our Santa Bárbara Medical Center is an accredited surgical center fully equipped to ensure you excellent care. When your procedure is completed, you will be taken to the recovery room. Later, you will rest in a comfortable room. Some medications will be prescribed to minimize any discomfort. You will be carefully monitored to observe any adverse side effect to anesthesia. You will stay in our medical center until Dr. Espinosa feels sure you have completed your recovery phase. You will receive specific home-care instructions and prescriptions for medicine. Be sure to arrange for someone to drive you home and to stay with you at least for the first night following the surgery.

¿How long will I stay in the operating room?

It usually takes from 1-1 ½ hours.  When malarplasty is performed in conjunction with other procedures, it may take little longer.

¿What should I expect after surgery?

Most chin augmentation procedures are done on an out-patient basis. After surgery, you will be taken to a recovery room to be closely watched for 1-2 hours or until your physician considers you ready to go home. You will wake up quickly and comfortably, feeling no pain and experiencing no anxiousness. Be sure to arrange for someone to drive you home and to stay with you at least the first night following the surgery. As hours pass by, it is possible that you may feel some temporary discomfort that can be controlled with pain medication. As with all surgeries, swelling will be an issue. As time goes by, the swelling and bruises will dissipate. Remember that it is completely normal for you to feel some tightness or numbness due to swelling. This is part of your healing. Keep your head elevated during your recovery. Some minimal bleeding may occur during the first two days following surgery, which can be considered completely normal. You may be asked to use an antiseptic mouthwash several times by day, until the incisions are healed. Internal sutures will reabsorbable. The remaining sutures under the chin will be examined 24 hours following surgery and removed during the next two weeks. Dr. Espinosa will be in permanent contact with you to be certain you are comfortable. Please, do not hesitate to communicate with us if you are concerned about something you consider significant.

¿What is the recovery time from Blepharoplasty?

Most patients are able to return to normal activity quickly. However, this will depend on the individual patient. You should resume gradually your normal daily activities after two days. Take your time to recover. Healing from surgery takes some time. Because swelling may still be present, patients who are very concerned about privacy take two weeks to recover. Schedule your surgery, so you have proper time to recovery. It may take some weeks for you to observe the results. Final results after a chin implant are not apparent for one full year following surgery. This is the time needed for body to recover.

Dr. Espinosa´s special instructions:

Instructions before surgery:

1. Avoid taking Aspirin (acetyl salicylic acid) or anti-inflammatory medicines.
   
   
2. Stop smoking at least one month before your surgery.
   
   
3. Inform your surgeon about drug allergies, medical treatments, and current medications.
   
   
4. Always have realistic expectations about the results of surgery.
   

Instructions after surgery:

1. Before you leave the medical center, make sure you have your surgeon’s prescriptions, medical certification, and date of your first post-operative visit to the office.
   
2. Stay on a liquid diet for the first two days.  Then a soft diet is recommended for five days.
   
3. A bandage will be placed around your chin.  Keep this bandage dry.
   
4. Cold compresses may reduce swelling.  You will be instructed by Dr. Espinosa to use a surgical glove filled with crushed ice, as a compress, over your chin.
   
5. Keep your head elevated during your recovery.  Sleep on your back with your head elevated the first 48 hours.  It is necessary to sleep strictly on your back so as to prevent swelling.  Sleep on two pillows to keep head elevated or use a wedge-shaped foam pillow.  You must sleep face up.
   
6. You must rest at home during the first 3-5 days.
   
7. You will be given prescriptions for use following surgery, including an oral antibiotic, swelling medications, and pain medications.  If you have severe pain, inform Dr. Espinosa immediately.  
   
8. Keep your mouth clean.  You must use dental floss and toothbrush from the first day following surgery.  Brush gently near the surgical area.  Rinse your mouth after every meal, (one half of chlorhexidine mouthwash to one half of physiologic saline moisturizing).
   
9. You may feel changes in sensation in the lower lip, including tightness and numbness. Because the nerves around the operated area of the skin are involved, a temporary loss of sensation may occur.
   
10. Remaining sutures will be removed 5-7 days following surgery.
    
11. You must avoid any activity that increases the risk of being hit. Lifting heavy things, animals or children may affect the area of surgery..
    
12. Excessive exposure to sun in the first 2 months following surgery may result in prolonged facial swelling and injury to the skin.  Thereafter, you should always protect your skin with a strong sun-screen.  Exposure to sun should be limited or skin discoloration may occur.  You must be protected under an umbrella or a hat.  Wear sun glasses.  Try to keep out of the sun as much as possible.
    
13. Avoid strenuous activity, including exercise and sex.  Do not carry or lift heavy objects for 3 weeks.  Light aerobic exercise is allowed just 3 weeks following surgery.   Return to normal aerobic exercise after 6 weeks.  However, Dr. Espinosa will observe your recovery and will let you know when you can resume your usual physical activities.
    
14. You can gradually resume your normal daily activities in about 8-10 days, as long as you avoid strenuous activity and protect yourself from hitting.
    
15. You should expect swelling in the operated area for three weeks.  You will be approximately 90% healed at 3 weeks.  You may start to see results quite quickly, but you will not see the final benefits of your surgery for 6 months following surgery.
    
    

The information provided here is not a substitute for a consultation. Please, do not hesitate to communicate with us if you are concerned about something you consider significant. Your post-operative appointment is really important. Remember, the success of your surgery depends very much upon post-operative care. It is crucial that you follow your surgeon’s instructions.