This is an operation undertaken to change the shape of the chin.
Dr. Michael typically undertakes augmentation mentoplasty procedures where a small chin is made more prominent by inserting an implant underneath the skin.
This may be undertaken as a procedure in its own right or more commonly performed together with a rhinoplasty (nose job) to achieve a more balanced result.
What happens before the operation?
In your first consultation, Dr Michael will take a detailed history about concerns that you have with your nose. If the operation is being undertaken to help compliment a rhinoplasty, you will also be asked about issues with your nose and have an endoscopy. You will have photos taken of different views of your chin. With regards to cosmetic procedures, it is important that individuals have a clear understanding of what an operation can achieve together with its limitations and potential risks. Hence, the majority of patients will be seen for a second visit prior to proceeding with surgery.
At your second appointment Dr Michael will talk through the operation. This will be done with the use of your photographs, scans and may also involve computer aided modifications to help illustrate the operation. If you wish to proceed with surgery, final consent forms will be completed.
It is important that you stop smoking two weeks before surgery as smoking affects blood vessels and hence the blood supply to the skin. Please also cease medicines that may increase bleeding, three weeks before the operation. These medicines include anti-inflammatory medicines such as Aspirin, Nurofen and Voltaren and also some herbal medicines containing garlic, gingko, ginseng and vitamin B12. Also, you will be asked to rinse your mouth with an antiseptic solution three times per day in the three days leading up to your surgery.
You will also be seen immediately before the operation and Dr Michael will answer any further queries that you may have before final consent forms are signed.
What does a mentoplasty operation involve?
Patients undergo the operation with general anaesthesia which means that they are asleep and are unaware of the procedure and do not feel any pain. Mentoplasty may be undertaken through cuts underneath the chin or a cut just inside the lower lip. Dr Michael favours the latter approach but on occasion an external cut may be more appropriate. Next, the implant is placed in a pocket that is made under the skin and secured. Absorbable stitches are used in the mouth. These usually dissolve over the course of a week. If a mentoplasty is undertaken as the sole procedure, you will usually be able to go home the same day.
What happens after the operation?
There will be some discomfort in mouth opening and chewing but this usually settles over the course of the following few days and should be controlled with Panadol. In this time, a soft diet is more comfortable and rinsing your mouth with a solution hydrogen peroxide or warm water a few times per day is beneficial. Sleeping on an extra pillow or two also helps to reduce swelling. You will also be given antibiotics to take for five days.
You should be able to return to work after your first follow-up appointment which is undertaken about 1 week after your operation but avoid sleeping on your face and strenuous exercise for 2 weeks.
Are there any risks to having the operation?
Some bleeding may be noticed within the mouth over the first post-operative day.
Blood leaking from broken blood vessels may collect under the skin. This is called a haematoma and may require a small procedure to drain any collection.
Although an implant is used, infection is rare. If this does occur, the implant may need to be removed.
When making the pocket to accept the implant, muscles under the lip need to be divided. These are re-approximated at the end of the operation and apart from some initial tightness, no others issues are usually noted. However, rarely the function of the lip may be affected.
The nerve that supplies sensation and chin muscles may be damaged. This is specifically looked for and avoided to minimise this risk.
The implant may move in position. This is minimised by securing it place to the chin bone by stitches and sometimes with a small screw.
There are general risks from the anaesthetic. Minor risks of nausea and vomiting may occur but can be managed by further medicines. Risks of serious complications are extremely rare. As a comparison, a general anaesthetic is considered to be much safer than road travel.
Dr Michael follows up his patients for at least one year to ensure that the surgical outcome is optimal. However, while absolute perfection is always aimed for, this may not be achievable in light of the intrinsic structural elements of tissue and healing.