The chin implant is done first since, because the implant is a foreign body, it is very desirable to minimize its exposure to air. The surgery is done through an incision that is beneath the chin. The implant is made of solid silicone and comes anatomically shaped. After it is placed on the front of the jaw, it is pinned into position with titanium screws. This is done to prevent later migration of the implant. Titanium is used so that should special radiological studies be required for any reason in the future (usually unrelated to the surgery), i.e., CAT scans or MRI’s, titanium will provide the least interference with those studies.
The incision for the rhinoplasty is usually made transversely through the columella, e.g., the tissue separating the nostrils. When the bump on the nose is small, it is reduced using hand rasps; when the bump is large it is done with electrically powered rasps. The nasal bones are then broken so they can be moved into proper position. Very often when the chin is increased in size, less has to be removed from the nose. At the end of the procedure a nasal cast is placed. The nose is not packed.
In the post-operative period, there is remarkably little pain. The cast and any external stitches are removed about 5 days later. Most people are able to drive after 3 to 4 days and can return to work after 10 to 14 days. It is important to understand that the result will not be final until one year from the surgery.
Dr. Moss has also found that for many of his breast augmentation patients in Boston, rhinoplasty surgery is a popular addition. Many of these women, who are young and in shape want to make an improvement in both their body and facial appearance. This combination makes a lot of sense in light of the fact that on a national basis, breast augmentation and rhinoplasty surgery are the two most popular cosmetic surgery procedures in the United States.