Ronald J. Caniglia, M.D., F.A.C.S.
 If you look at your profile and draw a line down from your lower lip, your chin should meet this line. In many cases, the chin falls short of this line, resulting in a weak profile. Furthermore, the nose can appear more protruding on profile when the chin is weak. On either side of the chin is an area referred to as the prejowl depression. The significance of this prejowl depression is that it can make one appear to have more jowling of the check tissues than they actually have. A properly shaped and sized chin implant can significantly improve the overall balance of the face. Chin implant surgery can safely be performed on all ages, though it is best suited for individuals with deficient projection of the chin on profile or those with a significant prejowl depression.
Dr. Caniglia performs the chin implant procedure at the Plastic Surgery Center at Kierland. This AAAHC-accredited, state- and Medicare-licensed outpatient surgery center is located in the Caniglia Center in Scottsdale, Arizona. Most chin implant surgeries are performed on an outpatient basis and take between 30 minutes and an hour to complete. Dr. Caniglia performs all chin implant procedures under local anesthesia with intravenous sedation, also known as deep twilight sleep. Deep twilight sleep has many benefits over other forms of anesthesia as it allows the patient to be free of discomfort and remember nothing from surgery. In addition, patients feel much more alert and refreshed after surgery. All patients are monitored at all times before, during and after surgery by a board certified anesthesiologist.
There are two possible incision locations for chin or prejowl implants. One is inside the mouth or lower lip, while the other placement is hidden within the crease underneath the chin (submental crease). Dr. Caniglia often prefers the second incision location as it allows the implant to be placed more precisely with less incidence of injury to the mental nerve, the nerve which provides sensation to the lower lip area.
For the surgery, the patient’s natural crease underneath the chin is marked with a marking pin. After adequate local and intravenous sedation are administered, an incision is made in the submental crease. Using a special instrument, the periosteum or tough fibrous lining overlying the bone of the chin is elevated and a pocket just large enough for the implant is created. The shape of the chin implant is then determined, for instance a conventional chin implant, extended anatomical chin implant, chin-prejowl implant or prejowl implant. Sizes are then used to determine the appropriate size. The permanent implant is then opened and soaked in antibiotic solution before being placed within the pocket overlying the bone of the chin. The implant is secured internally with sutures and the skin incision is then closed.
Most patients feel very good, with little to no discomfort, on the day after their chin implant procedure. The chin may feel a little stiff or numb early on after surgery but this quickly resolves. The sutures are usually dissolving. By about 2-3 months after surgery, most patients forget they even had a chin implant. The implant will not be palpable and the chin should feel just like it did before the surgery. Some patients are able to return to work as early as a few days after surgery, while most if not all patients are back to work within 7 days. Heavy strenuous activity and exercise is best postponed for 2 weeks. There are very few risks associated with chin implant surgery but these may include bleeding, infection, numbness, extrusion or asymmetry.
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