Profileplasty is a term that some use to describe a procedure that combines both rhinoplasty and a chin implant to improve the overall profile of the face. When considering the overall facial aesthetics three areas anatomically are taken into consideration. The upper third, middle third, and lower third each have their contribution to the appearance of the individual.
The profile is primarily understood by the relationship between the nose and the chin. Evaluation for profileplasty considers this relationship. How does the nose look in comparison to the chin? Therefore, profileplasty considers these two anatomic structures and their relationship to each other.
Profileplasty
The first consideration for the chin is to determine the occlusion. That is do the teeth intersect and interact properly? Things like an overbite or underbite are malocclusion. These should be taken into consideration first. Once the patient has a normal occlusion then the chin anatomy is taken into analysis, a critique is made and improvement, if necessary. If the overall lower jaw is inadequate that must be put under a slightly different analysis.
If it is the chin is lacking in projection then a chin implant can solve the problem and improve this component of the profile. I prefer to do these operations from a small incision under the chin area. Implant details for example with height and projection are made preoperatively to achieve the best result.
The rhinoplasty component in my opinion is best done through the internal starless technique. Also referred to as the closed technique. These operations can and should be done simultaneously. Packing and splints are taken out according to our postoperative protocols and a mild compression dressing over the chin area is also essential.
Recovery is usually 10 to 14 days with some degree of postoperative care beyond that requirement and discussion as necessary. I am not in favor of fillers in the nose because I think they may compromise the blood supply. Therefore, I prefer a chin implant. A discussion in detail of facial aesthetics takes place during the initial and subsequent consultations. This is so the patient has a full and clear understanding of the goal. The goal is to maximize the appearance and aesthetic look of the face and profile.
Profileplasty can be a very life-changing combination of procedures enhancing the person’s sense of self and self-confidence.
THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
