Augmentation of the Chin with a Silicone Implant

ABSTRACT

A line is drawn from the nasal tip to the most anterior point of the lower lip. The distance from soft tissue pogonion to the ideal soft tissue pogonion is the amount of correction. Alloplastic augmentation does not correct the soft tissue in a 11 ratio. In the case of a patient having normal soft tissue(8~11 mm), the ratio of the soft tissue correction is 10.66. In the case of a patient having a soft tissue deficiency(less than 7mm), the ratio of the soft tissue correction is 10.8. In the case of a patient having a soft tissue excess(more than 12mm), the ratio of the soft tissue correction is 10.5. The length of the implant is required to be more lateral to the mental foramen by 1~1.5 cm for restoration of the prejowl sulcus. The posterior surface of the implant must be carved to shape precisely to the bony surface. I usually make several vertical etchings and 20~30 holes in the implant. The vertical etchings help expand the implant to securely fit the mandibular contour. Fenestrated silastic implants can be further stabilized with fibrous tissue ingrowth and future reconstruction if bony erosion occurs.