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Combining a custom wraparound jawline implant with a sliding genioplasty can be very effective when the chin requires a type or magnitude of skeletal change that is better accomplished with an osteotomy than with implant augmentation alone. The key concept is that the genioplasty establishes the chin position, while the custom implant completes and blends

For the Indian nose, I would separate the design goals somewhat differently in men and women because the same maneuvers—especially dorsal augmentation, tip projection, and alar narrowing—can produce very different aesthetic effects. Male Indian rhinoplasty The male goal is usually a stronger, straighter, more projected nose without feminizing over-rotation or excessive narrow...

Rhinoplasty in the Indian nose is often less a classic reduction rhinoplasty and more a structural reshaping operation. There is considerable regional variability across India, but a frequently encountered pattern is a relatively broad osteocartilaginous framework, thick sebaceous skin, limited tip definition, underprojection or tip ptosis, a relatively low or broad dorsum, a...

In a thick-skinned/tissue patient, a custom jawline implant generally needs to be designed around the fact that the soft-tissue envelope can substantially dampen the visible effect of the skeletal augmentation. Experimental work has shown that thicker facial soft tissue can reduce the apparent augmentation produced by a subperiosteal implant with estimatedestimated attenuatio...

Vertical chin lengthening by osteotomy is usually performed as a form of osseous genioplasty (sliding genioplasty). Instead of adding an implant to the bottom of the chin, the chin bone is cut and repositioned inferiorly, increasing lower-face/chin height. Modern genioplasty techniques can alter vertical height, projection, width, and asymmetry simultaneously. For straightfor...