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For chin augmentation, my preferred method if someone really needs a chin implant or chin augmentation, it’s a use a chin implant and not to use fillers or fat grafting even though I perform both fillers and fat grafting quite extensively. The reason for this is if someone’s got a really weak chin there is no way that fillers and fat will augment the area predictably and attractively. So, there’s an expression I always talk about which is like light replaces like so when you’ve got a bony absence of the chin. If you try to fill it with fat or fillers, it just looks like a fatty chin, it doesn’t look like a solid chin, that’s augmented. So that’s one problem. Our brain can determine when something looks fatty, full or like a solid implant going forward. Now, a little bit of augmentation sure I can put a little bit of filler or fat into the chin to help it when someone’s got a really weak chin.
And they’re saying, look, I don’t want a chin implant, just take some fat in there. It’s not going to give that result. The second reason is that fat and fillers are not that predictable in terms of the degree of augmentation, there’s some absorption of fillers or the absorption of fat. You’re not going to get a predictable outcome. There you can’t keep on going back and sticking more fat. In part of the reason as I just explained is that like replaces like you’re not going to get a bony augmentation, not a predictable outcome with those fillers. The next reason is that a chin implant can truly push those soft tissue complexes forward and hold those tissues in position without falling or elapsing back when you just put a soft tissue injection of fillers and fat, you’re just not going to get the results that you want. Now that being said, the chin implant can only augment the very bottom of the chin to provide the augmentation where the mandible or the chin implant. it should be. Many years ago,I had a gentleman from Iowa that came in for a chin implant revision and I was shocked when I went in there. Take the implant out the implant was sitting over the dental roots and you can and he was already getting probably within a year or two going to lose his teeth because the implant was placed
over. Thin bone, you can’t do that. So you can’t put your chin implant way up high and that’s also where the mental nerves are where you have sensation issues. So you never want to put the implant way up high. That’s crazy. So the way to augment that area is then with fillers or fat. So oftentimes I can combine those two. So when you’re getting older, you lose the volume around the ant or the area near the lip between the chin and the lip and that could use fillers and fat. I call that the upside-down u, meaning that area that’s above the bony mandible that causes soft tissue loss.
Fillers are fat do really, really well to augment that. So you sort of have to understand when you’re looking at chin augmentation, what should be preferably a chin implant in certain patients and what are preferably fillers and fat. And again, as I said, if you’re just wanting a small augmentation, you’re not really interested in chin implant. You’re not looking to get that chin implant result which is a much more predictable, strong chin outcome, whether it’s a male or female, then a little bit of
fillers or fat can be helpful.