Chin Augmentation Techniques: A Systematic Review

Introduction: Chin augmentation has over the past decades maintained a high level of popularity among patients and facial plastic surgeons. Several procedures exist to enhance the appearance of a small chin. The aim of this study was to perform a systematic literature review to determine outcomes and complications associated to the different techniques described. Material and Methods: MEDLINE®, PubMed, PubMed Central (PMC) and Cochrane Central Registry of Controlled Trials (CENTRAL) database were screened using a search algorithm. The techniques were classified and related outcomes and complications tabulated and analyzed. Results: 54 studies on primary chin augmentation published from 1977 to 2020 met inclusion criteria, representing 4897 treated patients. Six main surgical techniques were identified: chin augmentation with implants (Silicone, Gore-Tex, Mersilene, Prolene, Medpor, Proplast, Hard Tissue Replacement (HTR), Porous Block Hydroxylapatite (PBHA), and Acrylic; n=3344); osteotomy (n = 885), autologous grafts (fat/bone/derma/cartilage; n = 398), fillers (hyaluronic acid, hydroxyapatite, biphasic polymer; n= 233), and local tissue rearrangements (n= 32), combination of implants placement and osteotomy (n= 5). All techniques provided consistently satisfactory cosmetic outcomes. The overall complication rate of the most represented groups was 15.7% for implants and 19.7% for osteotomy, including 2.4% and 16.4% cases of transient mental nerve related injuries respectively. Conclusions: All described chin augmentation techniques achieved good outcomes with high patient satisfaction. Perfect knowledge of each technique is essential to minimize each procedure’s specific complications. Caution is generally needed to avoid nerve injuries and potential over- or under-correction.