Chin Augmentation Techniques: A Systematic Review

Abstract

Chin augmentation has persistently been a popular procedure over the past decades. According to the American Society of Plastic Surgeons, approximately 16,500 procedures were performed in 2019. 1 The first description of chin augmentation was reported in 1934 by Aufricht, 2 who used the osteocartilaginous hump obtained from a combined rhinoplasty. In 1942, Hofer 3 introduced horizontal osteotomy performed through an external incision. Later, Trauner and Obwegeser 4 described an intraoral approach. The use of alloplastic material (silicone) as implantable material for chin augmentation was first reported in the early 1950s by Brown et al. 5 Osteotomies and implant augmentations became the most used techniques. In recent years, noninvasive procedures including injectable fillers have gained popularity and become largely used. Interest in Background: Chin augmentation has maintained a high level of popularity among patients and facial plastic surgeons. Several procedures exist to enhance the appearance of a small chin. The aim of this study was to perform a systematic literature review to determine outcomes and complications associated with the different techniques described. Methods: MEDLINE, PubMed, PubMed Central (PMC), and Cochrane Central Registry of Controlled Trials (CENTRAL) databases were screened using a search algorithm. The techniques were classified, and related outcomes and complications tabulated and analyzed. Results: A total of 54 studies on primary chin augmentation published from 1977 to 2020 met inclusion criteria, representing 4897 treated patients. Six main surgical techniques were identified: chin augmentation with implants (silicone, Gore-Tex, Mersilene, Prolene, Medpor, Proplast, hard tissue replacement, porous block hydroxyapatite, or acrylic; n = 3344), osteotomy (n = 885), autologous grafts (fat, bone, derma, or cartilage; n = 398), fillers (hyaluronic acid, hydroxyapatite, or biphasic polymer; n = 233), local tissue rearrangements (n = 32), and a combination of implant placement and osteotomy (n = 5). All techniques provided consistently satisfactory cosmetic outcomes. The overall complication rate of the most represented groups was 15.7% for implants and 19.7% for osteotomy, including 2.4% and 16.4% cases of transient mental nerve-related injuries, respectively. Conclusions: All described chin augmentation techniques achieved good outcomes with high patient satisfaction. Thorough knowledge of each technique is essential to minimize each procedure's specific complications. Caution is generally needed to avoid nerve injuries and potential overcorrection or undercorrection.

Transoral endoscopic thyroid surgery via vestibular approach with silastic chin augmentation genioplasty

“…Transoral vestibular approach thyroid surgery has become the most common established remote access technique to avoid the traditional transcervical incision or any other cutaneous incision since its initial description ( 2 ). Nonetheless, in some patients with thyroid disease, born with short chins and mandibular retrusion, chin augmentation techniques have achieved improved outcomes with high patient satisfaction ( 3 ). If transoral endoscopic thyroid surgery via a vestibular approach is performed in these patients, chin augmentation genioplasty performed in same incision and same period prevents further trauma ( 1 ).…”