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Plastic
Surgery |
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Chin
augmentation
The
facial skeleton and its covering soft tissues shape the features of the
face and the profile. The relationship between the different parts of
the face has a fundamental aesthetic importance. Well-marked cheekbones
give an aesthetic framing of the eyes, often by well-made make-up.
Principle:
Bone reduction is done by abrasion or chiselling, sometimes by moving
of a bony segment. Augmentation is done either with transplants of bone
or cartilage, mostly, however, with synthetic implants.
A surgical pocket is created and during healing, the implants will be
anchored at place by the surrounding connective tissues.
Some deformities and
asymmetries of the face need extensive pre- and postsurgical treatment
by different expert teams and these will not be discussed here.
The most performed
procedures are:
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Shortening
of the chin: Through an incision in the mouth to abrade or chisel
off a piece of bone. |
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Elongation
and widening of the chin: Through an incision in the mouth or below
the chin, a suitable implant is inserted. |
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Augmentation
of cheekbones: Augmentation through the mouth or during an eyelidoperation.
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Hollow
middle face: Augmentation through the mouth or the nose. |
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Narrowing
or widening of the lower face: Either augmentation or removing bone
of the angle of the lower jaw through the mouth. |
In all cases the implant
is adjusted according to desirable size and shape and given conditions.
The implants are fixated with tape/bandage for 5-6 days.
Anaesthetic:
Mostly local anaesthetic and conscious sedation.
Operating time:
1-2 hours.
What happens afterwards
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When
the anaesthetic subsides, a short intensive pain can be felt about
½ an hour. |
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The following discomfort is lessened with painkillers. |
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A
heavy swelling of the face evolves, that will dissolve in about 7-10
days. The breakdown can be accelerated with ice bags. |
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Prophylactic antibiotics are prescribed. |
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After
operations through the mouth, fluid food should be eaten the first
3 days. Otherwise mashed food. |
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Sleeping on the back is mandatory during the first 2 weeks. |
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Normal social activities can be returned to after 10-14 days. |
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Complications
Referred unwanted biologic events can occur with a certain low frequency
and must be regarded as calculated risks. Other risks not mentioned
can also occur. For patients this must be considered before a decision
for plastic surgery is set.
Bleeding: All operations can cause postoperative bleeding.
These risks increase by the intake of analgesics and Vitamin E.
These should be avoided 2 weeks prior to the planned operation.
Infection: All operations can cause infections. The mouth
is from surgical point of view heavy contaminated and in spite of
prophylactic antibiotics infection can occur. An implant has to
be removed temporarily and can be reinserted after a few months.
Displacement of an implantat: A correctly placed implant is
normally kept in place by scary healing to the surroundings. Occasionally
an implant can be displaced before proper healing. In that case
a reoperation is necessary.
Nerveinjury:
Facial implants are placed in near proximity to nerveexits of sensory
nerves. These nerves are protected during the operation. If the
implant, however, is displaced, it can irritate or damage the actual
nerve, which can cause numbness or pain in the corresponding area.
Smoking:
Smoking does compromise bloodcirculation and healing. Smoking should
be abandoned prior to a planned operation.
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