These cosmetic surgery procedures improve the structure of the face to provide increased strength and shape. Poor bone structure is a sign of aging and suggests weakness.
A prominent cheekbone gives the face a more triangular look, while highlighting the eyes. This traditionally has photographed well and, in the past, has been the look of many fashion models.
Chin implants provide strength to the lower face, and produce greater facial harmony.
In both cases, augmentation is made deep under the skin on the bone so that it is concealed and not detectable. All incisions are hidden within the mouth. They can be done under local, twilight or general anaesthetic, and both have relatively fast recovery periods.
How Chin and Cheek Implants surgery is done
Chin augmentation is a popular operation to provide increased definition of chin. A strong chin gives a sense of strength and character. Mr Golchin carries out chin surgery by making incision inside the mouth between the teeth and the lip. The incision measures approximately 2 cm in length and usually heals so well that even a dentist may not see it during routine dental care.
The augmentation is carried out either on the bone of the chin or over the layer of connective tissue, which sits on the bone. In either case it is very deep indeed. The augmentation is not carried out within the skin. Consequently the skin can be moved over the area and once it heals it feels like a normal chin.
The procedure requires dissection through the incision to expose the area of the chin bone. The area of augmentation is planned carefully to determine the level of protrusion and width and exact position. These areas over the chin are elevated to allow the augmentation to take place.
Many materials can be used for chin augmentation ranging from natural materials of the patient’s own body or a prosthesis. Mr Golchin prefers the silastic prosthesis as it is very flexible, permits easier introduction through a smaller hole and easier removed. Mr Golchin has not had problems with infection and extrusion of chin augmentation prosthesis and finds it an extremely reliable and satisfying operation.
There is usually swelling, limitation of lip movement and special care for the diet in the week following this surgery. Most people find the swelling will settle over a period of weeks, perhaps months.
Cheek Implants or Cheek augmentation is carried out in order to provide greater definition of the cheekbones. Cheekbones are solid and therefore solid augmentation is ideal here. Solid cheekbones provide a foundation for the eyes and are regarded as a sign of strength.
Access for this procedure is carried out inside the upper lip on the cheekbones. This section is carried out over the bone to create a pocket for the cheek implants materials to sit. The materials are inserted on each side, held in place and the area is closed.
Cheekbone augmentation requires careful planning and marking and measurement in order to ensure that the outcome fits the planned changes. Mr Golchin prefers to use silastic materialsfor cheek implants, as these materials can be folded to insert through a very small pocket into the field. This reduces the risk of any possible rejection and infection.
Can I use “natural materials” for implants?
Chin and cheek implants essentially are augmenting the skeletal structure of the face. Consequently, solid implants on the underlying solid bone has a real advantage in providing a natural enhancement of the skeleton. Solid pre-made implants allow fairly accurate placement and prevention of any movement. Lying directly on the bone all of the soft tissues can be easily moved over the implant so that the implants feel like the normal skeleton.
It is possible to augment the soft tissues over the implant using materials such as fat or other artificial products. The problem with this approach is the risk of irregularities and a thickening of the soft tissue, which is unnatural in that location. For this reason Mr Golchin prefers solid materials on those skeletal points.
However in the sub malar region, which is the area immediately under the cheekbone, or in the lips, Mr Golchin always prefers soft tissue fillers. These fillers need to be very mobile. It would be undesirable to feel solid material in the soft parts of the cheeks or in the lips. These areas need full flexibility and so soft tissue fillers are more appropriate in those locations.
Where are the incisions?
Mr Golchin prefers to make his incisions for cheek and chin implants within the mouth. This permits them to be hidden and reduce the risk that others may see the incisions. Some surgeons place chin implant incisions under the chin. This is a reasonable option but the risk here is that the scar may pucker or be visible. The intraoral incisions cannot really ever be seen except perhaps by your dentist.
Injury to the sensation of the lower lip is a potential complication, although one Mr Golchin has never seen. Further, asymmetry and difficulty in obtaining exact sizing is a risk, although very rare indeed with good technique. Adding 1 cm projection chin prosthesis will not always provide 1 cm of increased projection. In some cases a tissue reaction around the prosthesis provides a little extra augmentation and in some cases stretching of the skin and soft tissue over the chin prosthesis will thin the skin a little resulting in less than 1 cm protrusion. Nevertheless, these minute changes usually do not hamper the overall effect, which is planned and measured before surgery.
Other approaches have been used to chin augmentation by making incisions on the outside and fracturing the actual jawbone. Mr Golchin prefers to avoid any possible noticeable external incision for obvious reasons so that the patient has no obvious signs of having had surgery. Furthermore, the external incision does suffer the risk of puckering and irregularity aggravating the whole problem.
All patients have some facial asymmetry and this will always be evident after cheek augmentation, as it existed before. The level of asymmetry is usually very mild indeed but is always more noticeable when looking for it.
Apart from asymmetry mentioned above, risks include damage to nerves of movement or sensation around the cheek and lip. This is very rare indeed. Other problems might be infection or rejection of the materials and bleeding, again all of which are very rare.
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