Relationship of chin to nose
There is an inverse relationship between the appearance of the nose and mentum. A large nose makes for a smaller-looking chin, and a larger mentum makes for a smaller-looking nose! This relationship is so common that fully 10% of patients undergoing a rhinoplasty, or nose surgery, also need to have a chin augmentation performed at the same time.
Relationship of chin to neck
A large neck or one that has an obtuse cervicomental angle (i.e., no definition between the neck and the chin) will give the appearance of a small chin. In these patients, a small liposuction of the neck is all that is needed to reduce the size of the neck and give the appearance of a larger chin, without actually requiring any surgery on the chin itself.
Mentoplasty, or chin enlargement
There are two forms of mentoplasty: with implants and with mandible (jaw bone) surgery.
Silicone and other materials can be used for chin enlargement. I perform these surgeries under local anesthesia through an incision placed under the jaw, where most of us have a natural crease. Silicone implants come in many different shapes and sizes from which patients and their cosmetic surgeons can choose. Surgery lasts about one hour, and though most patients can return to regular social life within a few days, the healing period typically lasts six months or more, as the swelling takes a while to go away. Risks of the surgery include infection, malposition, implant movement, nerve weakness of the lower lip and numbness. Techniques in which the implants are placed through the mouth disrupt the muscle attachments of the chin to the bone and carry higher rates of infection; such techniques are best avoided.
Another method is to actually cut the jaw bone, move it forward and keep it in a new position with plates and screws. This method is best if the amount by which the chin must be brought forward is larger than can be achieved with a simple implant and in cases where patients have problems with dentition due to malformation of the jaws and teeth. These surgeries are much more complex, lasting several hours under general anesthesia, and they require a healing period that is weeks long. Complications are likewise much more serious.
Chin augmentation is increasingly performed to improve the profile of patients undergoing facelift surgery, as there is a definite resorption of the mandible bone with age. A small implant can add a touch of youth!