This was the question:

I’d like to get some information on chin shaving. Overall, I’d say that I have a chin that is long (in the vertical direction). I would estimate my reduction would be somewhere around 7-8 mm. I read a blog website that chin reduction in the vertical direction is usually done via removing a wedge between the upper and lower portions of the chin, rather than shaving off the bottom – where a witch’s chin deformity may result. Is this the procedure you would recommend, or it is just one Dr’s preference ? Would this procedure be done under general anesthetic ??

That is one way of doing things.  But if you read more articles on chin shaping (Dr Young is in Bellevue, near Seattle WA), the articles reflect the opinion of many people doing this, is that when you cut a wedge of bone there are other risks.  You are more likely to get nerve damage.  After you remove the middle part of the bone, it usually creates a step off on the sides that makes it more difficult to smooth out.  Also after doing the wedge of bone you need to use plates and screws to fix the bone cuts.  The bone that is left also has the potential to become devascularized and lose volume.  Also this method doesn’t allow you as much room for contouring the soft tissue after the reduction. If you try to contour the soft tissue like skin etc you can further devascularize the bone segment. Also this procedure can be done under local and iv sedation.  Also I would approach this from the outside under your chin.  I would not go through your mouth as this leads to more complications. Here is a video on chin reduction for you to see.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

So a common question is would I benefit from a chin augmentation (Dr Philip Young Seattle/ Bellevue Wa)?  I addressed this question in a recent blog but I didn’t talk about the vertical component.  How much vertical augmentation do I need and do I even need to add anything to the vertical dimension of my chin? Firstly, it is good to have some anatomical terms to refer to. In the first picture, the Glabella, labelled “G” is the most projecting point on the lower parto f the forehead and is usually right between the eyebrows. The nasion, labeled “N”, is the most depressed point below G and is usually at the root of the nose.  The Subnasale, labeled “SN”, is the point of transition from the nose to the upper lip.  It is where the nose, columnella, intersects the upper lip.  The upper vermillion is the point of transition from the white part of the upper lip to the red portion of the lip (Called the Vermillion) and is labeled “VU”. The same point coinciding with the lower lip is labeled “VL”. The Pogonion, labeled “PG”, is the point of the chin that is the most projecting anteriorly.  The mentum, labeled “MN”, is the most inferior portion of the chin.  One thing to be careful of is when the patient has a double chin.  The mentum is the part of the chin that is associated with the chin and not the inferior part of the sagging that can occur under the chin and posterior to the chin. The first rule for vertical augmentation is based on three lines drawn through the glabella, subnasale, and mentum.  Each of these distances created by these lines should be equal.  If your chin is making the distance from the mentum to the subnasale shorter than the distance from the subnasale to the glabella, you could benefit from a vertical chin augmentation.  If it is longer than you could benefit from chin reduction. This is shown in the second picture.  Now, if you draw a line through the nasion instead of the glabella the distance from nasion to the subnasale should be 43% and the distance from the subnasale to the mentum should be 57% o the total distance from nasion to mentum.   If the your distance from subnasale to the mentum is less than 57% you could possibly use some vertical enhancement.  the In the third picture, three lines are drawn through the subnasale, stomiom (or the opening between the upper and lower lips), and the mentum. The ratio of the distance from subnasale to the stomiom to the distance from stomiom to the mentum should be 1:2.  If the distance from your stomiom to the mentum is less than this ratio, you could benefit from vertical enhancement or an increase of the vertical dimension of your chin.  Below are some results of chin augmentation for you to see how a chin implant could enhance your appearance.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Profile Landmarks

Facial Thirds

Mouth Ratios

Before Chin Augmentation

After Chin Augmentation

Before Chin Augmentation

After Chin Augmentation