墊下巴整形

常常有患者擔心，如果原先下巴就有疤痕，或是下巴本身就偏向一邊的人，適合墊下巴嗎？我們在此特別舉出一些例子說明，解除患者的疑惑。

案例一：下巴原來就偏向一邊

左圖：手術前照片，明顯的發現，下巴偏向右側

右圖：植入依照下巴形狀雕刻的人工軟骨，改善了歪斜的下巴

案例二：下巴存在外傷性疤痕攣縮

左圖：手術前，下巴有攣縮的疤痕，影響外觀

右圖：手術分離沾粘的疤痕，並且植入人工軟骨，改善外觀之外，並且同時避免疤痕再度沾粘回去

一般來說，下巴內縮或是下巴發育較差的患者，往往會讓別人有"娃娃臉"的評語。這樣的評語，如果往好處想，意思看起來年輕，可是往壞處想，則是表示此人的外貌，看起來不成熟的意思。

確實，如果你面對一位下巴短的推銷員，是不是會感覺，對他的信心較為欠缺呢？青春期前的小孩子，稚氣未脫，看起來臉比較短，下巴也比較短，到了青春期，下半張臉開始拉長，臉部也出現一些較為明顯的線條，看起來就逐漸比較像可以靠得住的大人了。

反之，到了成年，下巴仍然不發育，潛意識中，就會讓對方有"不牢靠"的感覺，這種印象，在做完整形手術之後，會有意想不到的改善。

案例一：墊下巴同時頸部抽脂

左圖：手術前，下巴短小，合併有輕度的雙下巴問題  右圖： 墊下巴＋頸部抽脂，手術後照相

有的患者，原先的下巴形狀不規則，或是有缺陷的，也可以藉著墊下巴整形的時候，藉著雕刻技術，改善下巴的形狀。

案例：下巴中央凹痕填補

左圖：手術前，下巴中央凹陷，臉頰凹陷

手術內容：自體脂肪注射豐頰＋墊下巴整形

右圖：手術後照相

就牙科醫師的立場，如果上下牙床有點向外暴，那麼當然最好就是裝上鋼架矯正啦！如果考慮牙齒矯正，在整形外科醫師的立場，我要提醒妳的是：

1.如果是為了更美，牙齒矯正後，上、下牙床都後縮，齒列有可能會變美，但是卻可能突顯患者原先存在，鼻子或是下巴於美學上的缺陷。

2.矯正牙齒，有可能須要犧牲原來完美的咬合面，或是拔掉好的牙齒，最好的結果，卻仍然須要經年累月的鋼絲調整、固定工作，冒著牙齒清潔困難、長蛀牙的危險。反之，如果可以靠美容手術，不著痕跡的改善外貌，卻只須要數天的功夫，就可面貌一新，何樂而不為？

案例：隆鼻＋墊下巴，改善聯合暴

左圖：手術前，上、下牙床微突。

手術內容：墊下巴整形，同時移植耳朵軟骨墊高鼻尖。

右圖：手術後五天照相，仔細比較發現，除了人變更漂亮之外，感覺嘴巴也向後縮了。

問：

如果是要做墊下巴的手術，冒昧請問您，手術的費用大概要多少呢?

答：

墊下巴手術費用，初次手術、狀況不複雜者，約9.6萬~12.5萬元。重複手術或是狀況較為複雜者，例如上唇局部曾經做過牙床切開手術，下巴曾經注射任何填充物,或是曾經於其他院所，做過正顎整形手術者，需要酌增收費。

張醫師

有的患者墊下巴整形之前，會特別提及少數幾位藝人的下巴，希望不要做成像她們一樣突兀的長下巴。其實墊下巴整形的技巧，要靠醫師的審美眼光，與精確的定位觀念來達成目標。請看案例：

左圖:手術之前下巴後縮,而且顯得有點長     右圖:經由口腔黏膜植入人工軟骨,將下巴向前稍微墊厚一些,看起來下巴反而顯得縮短了.

墊下巴整形，到底切口在哪比較好？

1.經由口腔黏膜微小切口,植入人工軟骨,消腫快ˋ疼痛少ˋ又沒有任何疤痕,可說是第一志願的選擇.

2.經由下巴下方皮膚切口進入,植入人工軟骨--在本診所極少使用這種方式.適用時機:口腔衛生差,或是預定黏膜切口處疤痕過為嚴重,不適合進行手術者.

墊下巴整形，手術後須藥包紮嗎？

一般來說,下巴整形之後,外表上不須藥包紮敷料或膠布.本診所進行下巴整形的案例中,約有>90%的患者,手術後都沒有產生淤血或是明顯的腫脹,所以如果不希望同事ˋ朋友知道,通常不難瞞過親友.

From Reuters Health Information Best Face Forward: Chin Implants Surge in Popularity Print This Email this By Lauren Keiper BOSTON (Reuters) May 03

- Over the last year Dr. Darrick Antell has performed up to three or four chin implants a day, reflecting a national trend that has seen chin augmentations emerge as the fastest growing plastic surgery procedure of 2011.

路透社2012年5月3日報導:波士頓的德瑞克醫師現在每天進行3~4個墊下巴整形案例,凸顯出去年當中美國墊下巴人口快速增加的事實.

After about a 45-minute outpatient procedure and a bill ranging from $3,500 to $7,500, Dr. Antell's patients emerge with what he said is a confidence boost: an athletic, youthful look from a more prominent chin. "People want that leading lady, leading man look," said Dr. Antell, who is an assistant clinical professor of surgery at Columbia University in New York.

墊下巴手術時間約須45分鐘,費用約為美金$3,500 to $7,500,哥倫比亞大學外科助理教授安特爾醫師說,患者們希望成為頂尖人物,手術後患者普遍感覺比較健美,年輕,顯得更有自信.

"If you look at people in the limelight, they all have strong chins and it's a part of the profile that has long been overlooked," he said.

安特爾醫師說:"如果你注意那些鎂光燈焦點下的人們,你就會發現以往長期被人忽視的事實,就是這些人都有堅定的下巴."

Chin implants surged by 71% in 2011 as more than 20,600 adults went under the knife to sharpen their jaw lines, up from roughly 12,000 the year before, according to the American Society of Plastic Surgeons.

美國2010年墊下巴案例約為12.000例,2011年成長成為20,600例,成長了約71%.

Strong chins are associated with leadership, confidence and honesty, Dr. Antell said, not to mention some powerful men and women. "Romney's got a great chin," Dr. Antell said of the presidential hopeful. "Obama has a pretty good chin. Bill Clinton has a very good chin."

POPULAR AMONG MEN AND WOMEN Chin implant surgery increased more than breast augmentation, Botox and liposuction combined last year with both men and women opting for the procedure in nearly equal numbers, according to the American Society of Plastic Surgeons.

Chin augmentation, or actually making the chin protrude more, increased among all patients over the age of 20, with the most significant increases in patients 40 and older, according to the society.

Facial aging tends to appear first on the chin and jaw line and surgery provides a quick change, experts said. They also point to video chat and online photo technology as driving forces behind the escalating numbers. Posting pictures on Facebook, online dating sites and the increasingly prevalent use of video chat technology like Skype and FaceTime make it harder to hide a person's least favorite feature or perceived flaws, said Dr. Malcolm Roth, president of the American Society of Plastic Surgeons and the head of plastic surgery at Albany Medical Center in New York.

"We tend to not look at what we don't like," said Dr. Roth. "I think there is a heightened awareness to how we look to the outside world." The surgery is even appealing to people out of work, according to Dr. Roth, who said the cost hasn't deterred some who say it gives them more confidence at job interviews.

Chin augmentation can be done by putting a semi-solid implant on top of the chin, by moving bone to reconstruct the chin or simply by using a needle and syringe for an injection to enhance the chin, Dr. Roth said.

The procedure leaves minimal scarring from a very small incision and is sometimes coupled with micro-liposuction to trim a so-called double chin, enhancing the neck and jaw line even further.

Recuperation is easy and patients can typically be back to normal routines in a matter of days, Dr. Roth said. Despite the chin implant boom, breast augmentation still reigns as the most popular cosmetic procedure.

The surgery costs about $10,000 and more than 307,000 procedures were performed in 2011, statistics showed. Dr. Antell said he expects the chin implant trend to continue, largely because of the quick recovery and low complication rate.

He added that other similar, smaller scale procedures done at a younger age are also likely to climb. "This is an operation that whispers, it doesn't shout," said Dr. Antell. "Most people are not looking for huge changes, they are just hoping to look a little better, the best they can."