HOW IS DR. SHAH DIFFERENT?
Dr. Shah’s aesthetic values in the nose distinguish him from his colleagues. He does not believe in a singular form of beauty and as such has a wide aesthetic range. He believes in a customized approach for rhinoplasty. As such, he performs limited rhinoplasty cases per day. This is in part due to the massive amount of preparation and detail work required to create a nose at the highest standards. Dr. Shah has a diverse breadth of training in both open and closed rhinoplasty. He is well published in the scientific literature in facial plastic surgery and rhinoplasty, however, many of his techniques have not been published, presented, or performed elsewhere.
CHIN AUGMENTATION GALLERY
The before and after gallery represents a small fraction of the patients Dr. Shah has operated on. He has many more example of his work in his office. The gallery is intended to show a variety of aesthetics. All pictures shown are patients of Dr. Anil Shah.
Dr. Shah uses a specialized technique for chin augmentation he prefers the external approach to the intraoral approach for several reasons. First of all, intraoral chin implants must go through the mouth and thereby have a higher exposure to the bacteria in this area. Dr. Shah prefers to minimize the chance of infection. In addition, intraoral chin implants tend to rest higher on the chin and are often secured with bone screws.
Dr. Shah does not uses bone screws for chin implants. Bone screws involve placing either a metal or plastic screw through the chin implant. The issue with screws is that there will be some loss of bone along the jaw. Dr. Shah prefers a different approach. He preserves the covering of the chin bone, called the periosteum, along the center of the chin. The periosteum is like a carpet covering the bone. By preserving the periosteum along the center, he is able to place 4-5 sutures to secure the chin implant to the underlying bone. Some implants have wings to the end to further enhance the jowl and prejowl status. In these cases, he makes an incision along the lateral portion of the periosteum of the chin and places the wing of the implant underneath this area while still preserving the center portion.
Many patients seeking a chin implant are also looking for other area of their face to enhance. For patients with other procedures where general anesthesia or IV sedation is recommended, a chin augmentation can be easily added on as an additional procedure. For patients seeking just chin enhancement, Dr. Shah offers an in office alternative to patients not wanting general anesthesia.
Real Patient Testimonial:
Dear Dr. Shah, A quick note to say hello from Italy ! Thanks to you I look & feel beautiful! I thought you’d enjoy this postcard, as several doctors did an analysis of the celling of the sixteenth chapel and found that Michelangelo included detailed anatomical paintings (embedded in the ceiling) With best Wishes.
FREQUENTLY ASKED QUESTIONS:
What is Chin augmentation?
Chin augmentation is used to increase projection of the chin with an implant.
What materials are used in chin augmentation?
Several materials can be used including Silicone, Mersilene mesh, and Gore-tex. Silicone is my material of choice for several reasons. First of all, silicone is solid state substance which is quite different from injectable silicone or silicone implants. While injectable implants and silicone breast implants have the potential to leak, silicone chin implants do not. Silicone implants have an excellent track record of safety when used in chin augmentation.
How can I tell if I need a chin implant?
Your lateral view is the view where a weak chin will most likely show up. A weak chin may make a nose look bigger than it should and create an overall sense of facial weakness.
Is there anything I should be aware of before I have an implant?
You should notice any asymmetries of your face. Almost all patients will have a chin asymmetry. Some surgeons just place an implant in regardless of preoperative irregularity. This may accentuate asymmetry. I prefer to customize each implant to the patient but augmenting or reducing portions to help better balance the chin. Patients may still have asymmetry postoperative but it should be improved.
Your dental occlusion or bite is also important. If you have significant occlusion problems, alteration of your mandible may be a better choice.
What are some complications of chin implantation?
Most commonly is implantation shift can occur. The implant can be repositioned to improve the shift. Infection of chin implants is rare but can occur. Scarring can also occur externally
What are the approaches to placing a chin implant?
A chin implant can be placed orally or externally. The intraoral approach has the advantage of avoiding an external scar. However, the implant can become infected due to traversing the oral cavity which is laden with bacteria. Several studies have not shown a difference in rates of infection between implants placed externally and intraorally. Intraoral implants tend to rise superiorly due to the difficulty in creating a pocket laterally and fixating the implant in the midline.
External approach has the advantage of placing the implant through a sterile technique. The implant is more readily fixed in the midline and shift of the implant is decreased. The main disadvantage is that an external scar is made. However, meticulous closure will often times minimize visibility of this scar. In addition, the location of the scar is a place where very few people will be able to see.
Dr. Shah’s approach is to tailor the approach to the patient. Some patients request an intraoral approach and I will typically comply unless they have significant chin asymmetry or require a large chin implant.
Can I have a chin implant in the office setting?
Yes, more and more patients are seeking in office procedures. Dr. Shah is well versed in knowledge of facial nerves and blocks. As such, he is able to perform chin augmentation with great comfort for the patient in the office setting.
More and more patients are seeking chin augmentation. Patients are keenly aware of how the chin can impact the overall jawline and appearance of the face. One of the bigger fears is having anesthesia or going to sleep to have a chin augmentation procedure.
When a patient is having another procedure such as a rhinoplasty, it makes sense to have general anesthesia. However, for patients just seeking chin enhancement, Dr. Shah has perfected a new technique where he can have the patient have the chin procedure in the office. Dr. Shah performs a series of nerve blocks and infiltrates the area around the chin with a combination of anesthetic techniques. This makes the area around the chin momentarily numb. With the patient slightly relaxed but without an IV, Dr. Shah is able to place the chin implant.
Recovery from this procedure is quite quick. There is typically limited discomfort and pain afterwards and many patients are back to work in 3 days.
A female patient seeking soft subtle augmentation of the chin. Chin implants can be customized to the patient’s desired look.