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Chin Forward Sliding Before and After Surgery Photos

Homepage Star of October 2012
[ Author:Fushun Ma | Time:2012-11-09 23:30:40 |  Font Size: [Large Medium Small]
Tags: Chin forward sliding, chin augmentation, chin implant, small chin

Chin forward sliding, known as Chin Forward Sliding Surgery, or Sub Apical Horizontal Mandible Osteotomy Chin Advancement Surgery, or simply Chin Advancement Surgery, is a cosmetic surgery to move the chin forward and downward by horizontally cutting the chin bone and move the free piece of bone forward and downwardly. This surgery can achieve the effect of implant chin augmentation without inserting any foreign material into the body. More over at the time of making the chin sliding forward it also can make the chin move downwardly. This kind of chin height enhancement effect can't be achieved by any kind of implant chin augmentation.

Chin Forward Sliding needs an osteotomy at the chin bone and the front part of the mandible bone. Many candidates believe that bone surgery is a major surgery and thus fare to do theses surgeries concerning the safety of it. So they may wander between implant chin augmentation and chin sliding surgery. Though both kinds of surgeries could correct the small chin or chin retrognathia the sliding surgery has much more vantage than chin implant in term of satisfactory and long term surgical complications rate. Both surgeries could enhance the chin at the forward direction. However only the sliding surgery can move the chin lower down and make it narrower at the same time. Further more as the reason of foreign body exist, implant chin augmentation has more safety and reliability concerns than sliding surgery. So nowadays the capable institutes or surgeons tend to advise their candidates to do the osteotomy instead of implant. The cosmetic surgery seekers should also understand the advantages and disadvantages of these two kinds of surgery and make a right decision.

chin forward sliding surgery
In front view the major change after chin forward sliding surgery is the chin getting lower. This change make the face more proportional.

chin advancement surgery
In profile the chin is advanced forward and downwardly after surgery.

 chin sliding surgery
In angled lateral view the elongation effect of the mandible lower line is depicted.

horizontal mandible osteotoy chin advancement
Chin up, the change of the angle relationship between the chin and the neck is shown clearly.

Photo Analysis

Front view, this handsome young man has already had a longitudinal face. However his face looked wired somehow. If we take a deep look at his face we will notice that the height of his face below the lower lip is relatively shorter than it should be and this shortage make the face disproportional. Chin forward sliding could move the chin downward at the time of forward sliding when necessary. The downward movement make the chin lower and this change could be depicted at the front view most vividly. The face is still a longitudinal one after surgery. But as the proportion ratio between the lower and upper face is back to normal the face looks even more handsome.

In profile, the big problem was the relationship between the chin and the neck. As the chin was retrograded the angle between the chin and neck, also known as chin neck angle, was almost disappeared. The nasal tip, the lips, the chin and the neck was alined almost in a straight line. Also pre-surgically the angle between the lower lip and the chin was not deep enough. The surgery moved the chin forward so the degree of lip chin and chin neck angles are sharper and more naturally looking.

In lateral angled photo, this young man's original face gives an impression of protruding nose and lips. It seems that the nose and the lips are located outside of the facial parameter. Actually this is a misimpression caused by the retrogression of the chin. The nose and the lips are not protruding but the chin retrogression set up the nasal and lip protruding expression. The surgery seemed to pushed the nose and the lips back into the territory of the face. In this angle of view it is also noticeable that the length of the chin line is elongated.

In chin up profile photo, the biggest change concentrated on the lip chin angle and the chin neck angle. Compared to the before surgery photo the chin is bigger and more defined and the lip chin and chin neck angles are sharper post surgically. We can also check the relationship between the upper and lower lip due to the retrogression of the chin the lower lip is shorter and this makes the closure of the lips difficult. The chin forward sliding move the soft tissue forward when sling the bone forward. So the lips can close more easily.

Knowledge Regarding Chin Forward Sliding Surgery

Why the Chin Forward Sliding Surgery could make the chine lower, pointer and more protrusion.

During the Chin Forward Sliding surgery the front part of the mandible bone is cut free from the mandible body at the level below the apex of the lower set of teeth. The severed the free bone then is sliding forward to make the chin augmented. The distance of forward sliding varies depend on the patients will and the image study result of the mandible bone. At the time of surgery a specific fixation plate with certain arm length is applied to fix the severed free bone. Then a pre set goal of chin augmentation result could be achieved.

The amount of the downward movement of the chin also need to be calculated carefully before surgery in order to match the chin height with the other parts of the face. At the time of surgery the severed free bone could be moved and fixed accordingly to achieve the goal of making the chin lower. The distance of the forward movement of the chin can be as long as 20MM or more. However the scale of downward movement is limited to make sure the repositioned bone's survive and reuniting to the mandible body. In order to increase the downward movement scale bone graft can be inserted to fill the gap between the two pieces of bone.

For implant chin augmentation the thickness of the prosthesis is normally within 1.5CM. Otherwise the post surgical chin may look  unnatural or the prosthesis may expose due to the lack of soft tissue and mucosa coverage. While in Chin Sliding surgery the distance of chin forward movement could reach 20MM or even  more and the post surgery chin can still looks natural as stated above. The chin of this young man in this page is moved forward by 10MM. After surgery his chin looks good. If a 10MM thick chin implant is inserted the post surgery chin can hardly looks as natural and the shape of the prosthesis could eventually show on the skin in years.

There are several ways of making the chin narrower during the Chin Forward Sliding surgery. The easiest way of doing it is to trim the mandible bone at both side of the chin. Also a small piece of bone can be removed from the middle of the severed free bone to change its shape from a  "U" to a "V", thus the chin is narrowed. In recent years Dr. Fushun Ma use pillar fixation for chin forward sliding. With this technique the chin can be narrowed more easily and the fixation is more stable.

The size of the surgical incision and the surgical undermining scale is the same between Chin Forward Sliding Surgery and Implant Chin Augmentation. As the sliding surgery cuts a piece of the mandible bone free, moves it and than fixes it back. The osteotomy causes more bleeding and more chances of getting post surgery hematoma. So some of the sliding surgery patient may suffer longer swollen period and the swelling may seemed more severe. Nevertheless the swollen will eventually subsided. The sliding surgery does not leave any foreign body at the surgery site. The chance of post surgery infection is less than the implant augmentation.

For implant augmentation there is a prosthesis left in the body. No matter what is the nature of the implant they are all foreign bodies to the human body. Foreign body could cause short term and long term infection or rejection reaction. Though a strict anti microbial protocol is followed in every surgical procedure iatrogenic infections caused by the residual microbial in the prosthesis happens from time to time, especially those prosthesis with micro holes. New generations of prosthesis is getting more and more friendly to the human body. However no nasal augmentation prosthesis is 100% rejection free so far. The definite long term complication for implant is the surrounding hard and soft tissue absorption caused by the constant pressure imposed by the implant. For a chin implant the affected tissue may include the mandible bone and the soft tissue at the chin, so the shapes of most of the chin implant show beneath the skim many years post surgery as a result of soft tissue absorption which in turn compromise the coverage of the implant.

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