WHY CHIN PROCEDURES ARE GOING UP?

“Our face is a crucial component of making a favorable first impression. I routinely get young people in their 20s and 30s, who want to look sharp and convincing. To them, a proportioned face is part of the X factor and social winnability,” says Dr Sravya C Tipirneni, consultant dermatologist and cosmetologist at Manipal Hospitals, Bengaluru.

She also dispels the idea that chin and jawline enhancement are always about aesthetics. “Sometimes facial asymmetry (because no two sides of our faces are the same) is pronounced; There may be a deeper indentation on one side that distorts your face. Patients of Bell’s palsy (muscle weakness that causes one half of the face to droop) often need a correction to get the facial muscles back up. For patients of morphea, who lose face fat rapidly, fillers offer hope. Sometimes the collagen shrinks drastically in 50-plus people, hollowing out their cheeks, giving a sunken, broken appearance. This needs some plumping up and contouring,” says Dr. Tipirneni.

SURGICAL OR NON SURGICAL?

There are both non-surgical and surgical approaches. The non-surgical method involves injecting hyaluronic acid (a slippery substance that your body produces too and can hold water) and fat-burning fillers. “We inject them in different concentrations. Sometimes we need to enhance volume to increase the chin’s projection and in the process correct a receding chin. At other times, we have to align the chin that’s protruding too much with the upper jawline,” says Dr. Tipirneni. The injections have a numbing agent mixed with them, so pain is minimal, with temporary swelling and inflammation at the injection site. But it’s a day’s procedure. So you can walk out in 50 minutes and take care to avoid infection at the prick site.

Dr Adhishwar Sharma holds up a 3D-printed upper jawline of a patient to work out a realigned model for his chin. (Express Photo)

Dr Tipirneni does a 3D imaging of the patient’s face and then prepares a predictive model of the outcome on a computer. “There is a mathematical ratio involved. The ideal chin length is 1.6 times the length of the lower lip. There is another measure called the E-line, an imaginary line drawn from the tip of the nose to the chin. A perfect chin should become slightly longer than this line,” she explains.

Fillers are emerging as a safe option as they last up to 16 months. “Now we have needles tipped with straws. This reduces blood vessel injury and allows the dermatologist to place fillers in specific layers and consistencies for a more natural look. This avoids over-correction and allows you to mold the filler into a shape that would most suit the patient by gently massaging it, much like a play dough,” adds Dr Tipirneni.

However, the problem with fillers is that they will need to be retouched over the years. “Besides fillers cannot account for bone development disorders or structural defects from birth,” says Dr Adhishwar Sharma, cosmetic and plastic surgeon, Fortis Memorial Research Institute (FMRI), Gurugram.

He uses a 3D printer to make a replica of the chin and jawline, then takes at least four sets of measurements. “Bone gaps are sometimes thinner than human hair, so this meticulous process involves two months of pre-surgery assessment as well as six months of post-surgical follow-up. This is best for chins that jut out big and square like the wrestler Khali. Your upper and lower jaw are asymmetrical and the teeth don’t sit easily on each other. As a result, they have to be realigned,” he says.

For recessed chins, he recommends an implant around a patient’s existing chin bone to augment its size and shape. This is usually an outpatient procedure, performed using general anesthesia. A small incision is made either underneath the chin or inside the mouth. Through this incision, the surgeon creates space for the chin implant, usually silicone, and fits it around the chin bone. “But for a permanent effect, I would cut the bone a bit, bring it forward and fix it with plates and screws,” explains Dr Sharma.

COST OF PROCEDURE

One has to weigh the costs as well. A single dose of hyaluronic acid filler — 1 ml — costs Rs 25,000. “For full enhancement, you would need around 4 to 6 ml, which would cost anywhere between Rs 1 lakh to Rs 3 lakh,” says Dr Tipirneni. A surgery itself would cost around Rs 2.5 lakh. “Outpatient follow-up services do not cost that high. And although cosmetic procedures are not covered by insurance, reconstructive procedures that have to do with ease of body functioning are covered,” adds Dr Sharma. However, people are looking at these procedures as returns on investment (ROI), the kind that guarantees them body confidence.