If you feel your chin is too small while your teeth are in a good position, with the upper teeth slightly overlapping the lower teeth when you clench them, it is simply a matter of increasing the projection of the tip of the chin. The simplest method is to add material in front of the bone.
A fairly common method is to insert an implant, generally made of silicone. This implant is placed through a short incision hidden under the chin. However, the long-term tolerance of these implants is unpredictable, and I prefer the following technique using an osteotomy.
When the chin is more receding, or when it is too high, it is preferable to use an osteotomy (cutting the bone), which makes it possible to move the tip of the chin forward, like pulling out a drawer. There is some post-operative discomfort for a few weeks, but for significant recession this is a much more satisfactory anatomical correction than adding an implant. If, on the other hand, your chin is too prominent, as I have explained, it is possible to reduce it by removing the excess bone, also through an incision hidden inside the mouth.
When your occlusion (the way the teeth fit together) is not good, it is most often possible to put everything back in place with osteotomies, bone cuts, at the level of the upper jaw or the mandible. A complete assessment, with X-rays, photographs and an orthodontic evaluation, is then necessary to determine the ideal treatment that could radically correct a disharmonious profile (see our page on cosmetic surgery of the facial skeleton).
If the excess under the chin consists essentially of fatty tissue, which can occur even at a normal weight, liposuction of the neck may be necessary.
When a simple chin osteotomy is decided upon, it can be performed either on its own or in combination with a rhinoplasty. Anaesthesia is general, and the incision is invisible, inside the mouth. Some swelling follows, with little pain. The sutures dissolve on their own. A one-night hospital stay is necessary.
After a chin osteotomy, recovery is marked by swelling and bruising, with little pain.
It is advisable to wear a compressive lycra chin strap for one week, day and night, then for one week at night only. If a rhinoplasty has been performed at the same time, the chin strap is worn for as long as the nasal cast. A more or less pronounced numbness of the chin and lower lip may last a few weeks.
The final result can be assessed after 3 months.
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