Intraoral augmentation mentoplasty with a hinged silastic implant.

Considerable concern has been expressed in the past ten years of bone resorption secondary to alloplastic chin implants. Therefore, I describe a modification of the surgical technique and a type of implant. Twenty-five patients underwent augmentation metoplasty for moderate to severe microgenia during the past three years. Surgery was performed with insertion of a modified type of Safian's solid silicone implant with triangular wedges that were removed on the posterior surface, and the spaces that were created were replaced with soft, pore-closed, whit silicone sponge. All implants were inserted intraorally, since the central body was supraperiosteal, and the lateral extensions were subperiosteal. Two implants of the 25 cases were removed postoperatively because of infection. Nine patients were followed up for one to three years postoperatively with serial xerographic analysis of the chin implants.