Because of its long history and the large experience that plastic surgeons gained over the decades with this technique, implants for chin enhancement represent the gold standard in aesthetic chin surgery. Multiple materials used for facial implantation have been coming into fashion over the years only to fall out of favor. Today, primarily three implant materials continue to be used in the USA for chin augmentation including Silastic, Gore-Tex and polyethylene. Each of these materials has its pros and cons but use in millions of patients for facial implantation has proven their safety and benefits.
Silicone Chin Implants (Silastic)
Silicone refers to a synthetic material which is biologically inert and does not disintegrate or change over decades. The rubber-like consistency of elastic silicone used for facial implants allows for the implant to naturally follow the complex forms and shapes of the chin bone. Silicone chin implants have been used by plastic surgeons since the 1950s and continue to be popular and safe today. In Dr. Fechner’s practice, Silicone implants represent the preferred option for permanent chin enhancement.
Silicone implants are inserted through an incision placed either right on under the chin in a natural skin crease. Alternatively, an inside-the-mouth incision can be used located at the transition from gingiva to the internal lip lining. These implants are affixed right to the bone which then allows the chin soft tissues to drape over the new frame work. The healing of silicone-based facial implants is different from most of the other implant materials. Our soft tissues form a tight capsule around the implant which will hold it in place for decades to come. Therefore, many surgeons including Dr. Fechner belief that screw fixation of silicone chin implants to the bone is unnecessary. Rather, temporary sutures are preferably used by Dr. Fechner to stabilize the implant during the early and most important phase of healing. Although an extremely rare desire, the capsule formation around the implant also allows the cosmetic facial surgeon to easily exchange the implant for a different size or style if necessary or desired. In contrast, with most of the other materials, exchange can be rather difficult, cumbersome and sometimes even requires power tools.
Gore-Tex (ePTFE) Implants for Chin Augmentation
Just like silicone, Gore-Tex (expanded polytetrafluoroethylene = ePTFE) has been used extensively for surgical purposes. For instance, Gore-Tex found utilization for grafts in vascular and cardiac surgery as well as in hernia repairs. As a facial implant, Goer-Tex has not been used as long as silicone. It found introduction in the 1990s for augmentation of the chin, cheeks and nose. In contrast to silicone, as a porous material Gore-Tex allows for tissue ingrowth into the implant itself. This can have advantages as well as disadvantages. In-growth of inflammatory tissues and collagen into the implant helps to fix the implant in place. On the other hand, this may make removal of the implement difficult especially when the implant is in close proximity to important nerves and vessels. Although Dr. Fechner has used Gore-Tex as chin implantation material, it is not his preferred material today.
Porex (Medpor) Chin Implants
Polyethylene is the chemical that is used in a porous form for Medpor and Porex facial implants. Medpor implants have been used for structural benefits in the nose, ear, cheek and chin. Because of its inflexible, solid features, it is often provided as a two-piece chin implant that is reassembled during surgery. It has relatively large pores that allow for significant tissue in-growth. Removal of the implant for any reason will be difficult and sometimes will lead to unwanted tissue destruction. Dr. Fechner prefers silastic chin implants over facial Porex or Medpor implants.
If you need more information regarding chin implants, please contact us to consult with our specialists.