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Chin Forward Sliding and Mandible Reduction

Homepage Star of July 2013
[ Author:Fushun Ma | Time:2013-08-12 20:27:12 |  Font Size: [Large Medium Small]
Tags: chin forward sliding, mandible reduction, chin augmentation, implant

Chin augmentation is a popular and common cosmetic surgery. It is so popular that many candidates whose condition need a Chin Forward Sliding surgery is misdirected to undergo a chin augmentation surgery, because the augmentation surgery is miner and simple requiring less training for the surgeon and less sophisticated set up for the surgical institute. But the implant used for chin augmentation is foreign body to human. Many patients with chin implant eventually came back to the operation room to replace the implant with a chin bone forward sliding surgery after same years as they couldn't bear the discomfort and disfiguration at the chin. Similarly the early stage mandible angle reduction surgery only toke care of the angle of the mandible bone by cutting a piece of bone from the angle without good reshaping of the whole mandible and the masseter muscle. The post surgery facial figure is for sure not ideal and many patients has to do a revision surgery to improve their facial contour.

The pretty girl on this page did her chin implant augmentation and mandible reduction surgery many year before. But she was not happy with her post surgery result as she didn't like the contour of her lower face and also she started to feel pressure and discomfort at her chin for several years. When she came to see Dr. Fushun Ma and addressed her complain Dr. Ma did chin implant removal, chin forward sliding surgery and revision mandible reduction with partial masseter muscle resection surgeries. The girl is satisfied with the final result and her symptoms around the chin relieved.

chin forward sliding and mandible reduction surgery
Disfigure and discomfort after the primary chin augmentation and mandible reduction surgeries, chin forward sliding and revision mandible reduction improved the figure and relieved the symptom.

chin implant removal and chin bone forward sliding surgery
After the removal of the chin implant a chin forward sliding surgery was done. The shape of the chin looks natural afterward.

 chin forward sliding surgery
The chin implant is replaced by the sliding forward own chin bone. The chin is protruding forward more and the lip chin angle is deeper.

In the before surgery photo the height of the chin is not proportional to the face an impression of downward facial organs displacement is given. During work and everyday life Dr. Ma always contact girls with eyebrow bangs and wondering what was the reason for that since their face looked pretty. Late on Dr. Ma found out that a deep bangs that partially or completely cover the forehead could indeed make the facial contour more proportional for those whose chin height is not enough to match the face.

Implant chin augmentation can only make the chin augmented frontally, while the chin forward sliding surgery can make the chin higher and frontally protruded more. The post surgery photo of this girl shows the facial contour change after the height of the chin is increased.

Compared to the post surgery photo the chin is big, wide and pointed to the left in the before surgery photo because of the existence of the chin implant. Existence of any foreign body will induce atrophy change to the surround tissue depend on the pressure the foreign body applied to its surrounding environment. The atrophic change of the soft tissue overlay the implant left the shape of the prosthesis been revealed after a prolonged period. This girl's implant had already shown its shape on the skin in the pre surgery photo and this also made the chin look square. On top of that the thick sides of the implant itself also contribute to the square looking of the chin . The implant excavated from the chin of this girl is showing below.

The previous mandible angle reduction surgery didn't make the face narrower from the front view. During the revision surgery the size of the whole mandible was reduced and the masseter muscle was partially removed also. All those procedures meant to make the lower third of the face narrower. Combined with the effect of the chin forward sliding, the narrowing of the face constitute the change of this girl's face to a longitudinal one in front view.

In the angled view the chin is short and also the outline of the chin is not smooth with an indentation on the left side of chin. This is because of the uneven mandible bone hypertrophic osteogenesis stimulated by the implant. After the removal of the implant and the forward sliding of the chin this unevenness look is improved. The mandible bone and massetter muscle reduction made the mandible line of this angle of view longer and smoother.

After chin forward sliding surgery the chin is protruded to the front more and the lip chin angle is deeper. Though there is a chin implant in the before surgery photo of this set the augmentation effect of the chin is still not enough. The augmentation effect of the chin sliding overrun the implant.

CT image of the chin implant 3D CT image of the chin implant
After some years the implanted prosthesis is partially buried into the mandible bone due to the bone absorption caused by the implant's constant pressure on the bone.

The two images above are the sliced CT and 3D CT image of this girl's facial bone. The blue arrow indicates the gray implanted prosthesis. From this image we can see the prosthesis is sunk into the white bone tissue, in some part the cortex of the bone is almost disappeared and the prosthesis located very near to the bone marrow. The prolonged stimulation by the prosthesis also induced hypertrophic osteogenesis around the edge of the implant, seeing the white arrow. The depressed bone atrophy and hypertrophic bone overgrowth were the causes of the discomfort of the chin for this girl.

The 3D CT image on the right shows the labia like hypertrophic osteogenesis surrounding the edge of the prosthesis. The images blow is the excavated prosthesis from the chin of this girl. Compared to the real prosthesis the shape of the prosthesis in 3D CT image is quite irregular. This indicates the hypertrophic osteogenesis is not evenly spread.

the prosthesis for chin augmentation
The prosthesis excavated from the chin. Though it looks big the augmentation effect for the chin was not obvious because part of the prosthesis had been buried inside the mandible bone.

The above picture shows the prosthesis of chin augmentation for this girl. The size of the prosthesis is big enough at the front and on the sides, it seemed it had been inserted into the chin without any carving from the original factory style. Nevertheless its augmentation effect for the chin is not obvious as part of the prosthesis had been buried into the mandible bone indentation caused by overtime constant pressure applied by the prosthesis, seeing in the above CT images. The side of the prosthesis is thick and the hypertrophic osteogenesis of the bone was most prominent on the sides, all these elements constituted the square look of the chin. As mentioned above the atrophic change in the overlay soft tissue superficial to the prosthesis revealed the shape of the implant. With all these problems induced by the prosthesis implant chin augmentation one could hardly satisfiy the post surgery result.

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