IMPLANT SELECTION

Preformed solid silicone chin implants have been successfully used since Safian and Dow Coming (TM) introduced them in 1966. Improved design. host acceptance with minimal reactions. ease in handling, and the ability to securely fixate with sutures and custom-contour with a wafer makes preformed silastic chin implants our preferred chin implants.

There are three basic styles of available silastic chin implants. Standard, laterally extended and laterally extended with pre jowl augmentation. The term anatomical, which is used for laterally extended-shaped implants. is misleading because the correct choice of implants is what leads to an anatomically pleasing result.

The choice between a standard and a laterally extended implant is made preoperatively and is based on the patient's front view. The patient with a normal shape front view can accept either a standard or a laterally extended implant. The patient with a full round face requires gradual tapering from the lateral mandible to the central portion of the chin. The use of a standard width implant can produce or exaggerate a prejowI sulcus and the appearance of a jowl. On the other hand, a laterally extended implant in this patient wilI improve the contour of the jaw and produce a more angular and narrower facial appearance. The patient with a very narrow face benefits most from a laterally extended implant. A standard width implant can increase the narrow look of the face and even contribute to a more pointed chin appearance while the laterally extended implant fills out the lateral mandibular region. Familiarity with the technique of insertion of the laterally extended implants wilI make the surgeon as comfortable using this type of implant as a standard width implant. We routinely use laterally extended implants because they generally produce better mandibular contouring.

The presence of a prejowl sulcus or excessive jowling is an indication to use a laterally extended implant with in-creased augmentation in the region of the prejowl sulcus. These are marketed as chin-jowl implants designed by Mittelman (TM).

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