Dr. Andrew Barnett MD Cosmetic Plastic Surgeon

Chin and Cheek Enhancement

A tent without a strong frame is weak and poorly shaped, likewise the face. Augmentation and restructuring of the facial skeleton through simple implant techniques increases the strength and definition of the underlying structure with dramatic effects on balance, proportion, and definition.

-Andrew Barnett, MD

Chin and cheekbone enhancement surgery allows the skilled surgeon to alter the basic underlying structure of the face. A balanced facial form with a well defined jawline and cheekbones, and a slight hollow in the cheeks, is the aesthetic goal. While not to be taken lightly, chin and cheekbone enhancement can make a dramatic change in your appearance.

How exactly is surgery on the chin and jaw done?

Surgery on the chin is done through an incision inside the mouth, or sometimes underneath the chin in an existing skin crease. Through this incision, the bone of the chin is approached. The projection of the chin may be altered either through the use of a small implant, or by cutting the bone and shifting its position. The incisions are then closed and a small elastic dressing is applied. If the posterior portion of the jaw needs to be altered, this also is approached through an incision inside the mouth.

What about cheekbone enhancement?

Cheekbones are enhanced by an implant that sits on the prominence of the existing cheekbone, referred to as the malar eminence. The implant is inserted through an incision in the mouth, or through an incision in the lower eyelid, brow, or in front of the ear. The incision used depends on your particular needs and other surgery that may be performed at the same time, such as an eyelid lift.

What are the implants make of?

Implants are made of a plastic material which is considered biocompatible, that is, a material that tends to have minimal reaction when placed under the skin. The two most common materials are solid flexible silicone and gortex.

Is surgery painful?

Surgery is performed with an anesthetic, either local or general, so there is minimal discomfort during the surgery. After surgery, there is some discomfort, but this is generally well controlled with pain medication.

If my chin is too small, what are the options?

The most common procedure performed on the chin is an augmentation, or enlargement in a forward direction. It may be done as a procedure unto itself, but is also performed at the same time as nasal surgery and facelift surgery. Augmentation is performed through one of two methods. Implant augmentation is the simplest method. In this technique, a plastic implant is inserted to lie directly on the bone of the chin. This is performed with local anesthetic through an incision in the mouth or under the chin. The more complex procedure uses the intra-oral incision and involves a cut in the bone of the chin, sliding it forward and wiring it in place. General anesthetic is necessary and no implant is used. While use of the implant is more common, each technique has specific advantages and disadvantages.

What if my chin is too prominent, or too long?

In this case, reduction genioplasty is performed. Again, through the same incision inside the mouth, the bone making up the chin is reduced and slid backwards as necessary. This is also performed under general anesthesia.

What if the back portion of my jaw, below my ear, is to wide, or too narrow?

This area, referred to as the angle of the jaw, can likewise be reduced or widened. Techniques similar to those used for the chin are employed.

If my bite is not correct, or I have an overbite or underbite, can this be corrected?

Generally, yes. Different surgical techniques are employed and a comprehensive evaluation is necessary before deciding on the procedure that's correct for you.

What if I have a double chin, or turkey gobbler neck?

Double chins and turkey gobblers are actually problems with the skin, fat, and muscles of the neck. These problems are frequently seen with weak chins and can be corrected at the same time. My cheeks are quite full, and this seems to hide my cheekbones. Cheekbones are often hidden by "chubby cheeks". Cosmetic make-up is frequently used to highlight the cheekbones, by creating the impression of a cheek hollow. "Chubby cheeks" can be greatly improved by removing a collection of fat in the cheeks called the buccal fat pad. This is done under local anesthesia through a small incision inside the mouth.

How long is the recovery time from all these surgeries?

Surgery for these problems is generally performed on an outpatient basis, allowing you to go home the same day as surgery. A limited diet is prescribed for one week, followed by return to normal activities. The jaw is not wired, and only minimal dressings are used. Most patients are able to return to work in two to seven days. Bruising and swelling can sometimes last for longer periods of time, and temporary numbness of the lip may last for three to six weeks.

Are there risks with jaw and cheekbone surgery?

As with all surgery, there are risks of bleeding, scarring and infection. Nerves and muscles may be injured which can cause permanent numbness or alteration in the movement of the lower lip, though this is uncommon. The position of the implant can shift causing a slight asymmetry which may require a second surgery to correct. Injury to the teeth, while unusual, can occur. Additional risks will be discussed at your consultation. These risks are explained not to frighten but to inform you. Though they are real, they're quite small.

Should I have surgery to enhance my chin or cheekbones?

That's a question only you can answer. At your consultation, ask questions and explain your desires and expectations. We'll work together to make the decision that's right for you.

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“I am a registered nurse… so after a lot of research and speaking to other physicians and fellow nurses… my decision was made. He is an artist and I believe the best in his field. Now my favorite thing to do is shop for bras. Thanks Dr. B, you are truly the best.”

-AN, RN, Napa, CA

“As a physician, I know about physician hype and marketing, the go to surgeon nonsense… Having lived and worked in the Bay area for many years, when it was my time I asked colleagues who performs consistently excellent facial work. Your name came up repeatedly… While I was impressed with your professionalism, it is the artistic, balanced, natural result that reminds me everyday that I made the right choice putting my face in your hands. Thank you.”

-LC, MD, Palm Springs, CA

“When I tell people that I have two adult children, they look at me and say, “You must have been a child bride.” Well I love the look on their faces when I tell them I’m 63. Sometimes I say “You know, Dr. Barnett is my secret weapon”, but most of the time I just say, “Oh, I guess I’m lucky. Good genes…” If they only knew! You are wonderful.”

-JG, San Francisco, CA

415.362.1221

450 SUTTER STREET, SUITE 1123
SAN FRANCISCO, CA 94108

925.932.8982

112 LA CASA VIA, SUITE 350
WALNUT CREEK, CA 94598

Copyright 2014. All rights reserved. Andrew Barnett, M.D.