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Tuesday, May 4. 2010

Chin implants; I rarely perform them any longer.

During my fellowship training I learned to perform chin implants in patients with receding chins and to tighten up loose necks. I used a variety of silicone implants: natural, anatomic, wrap-around, etc, and even some custom made ones.  I would offer it to my facelift patient on a regular basis and the results were generally good. The only drawback was that the implants could rarely move, spit or get infected.

Recently I noticed that I am using chin implants less and less often.  Fat transfers and the longer lasting fillers (such as Juvederm Ultra Plus) have all but replaced chin implants in my practice.

Here are the advantages and disadvantages of using fillers to augment the chin and jaw line:


·         Control over size of the chin: Most Chin implants come is 3 or 4 sizes. It is exceedingly difficult to find the perfect size for a patient. Most chins are also a little asymmetrical (just like the left and the right foot are not always equal). A symmetrical chin implant can accentuate an asymmetric chin and worsen the picture. Fillers (Juverderm, Radiesse, and Fat) are placed in tiny droplets and can be used to not only build up the chin and jaw line, but also to correct minute irregularities.

·         Gravity: A chin implant is permanent but the face changes over many years and decades. Chin implants that look good when you are 35 may not look as appealing at age 65. Fillers and even transplanted fat resorb and go away in 12 to 24 months. This gives you a chance to re-shape the face every few years and maintain a youthful look.

·         Very little risk of nerve damage, infection, or unsightly scarring. I have seen chin implants (and to a much greater degree cheek implants) move. It is exceedingly difficult to remove them. This may injure the nerves and cause a lot of skin laxity.


·         I would say that cost is the biggest disadvantage of using fillers rather than an implant to augment the chin. Fillers have become less and less expensive and are lasting longer.

Overall I have come to prefer fillers as a superior choice to augment the chin and jaw lines.

A. David Rahimi, MD,FAAD.


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