These are bathed in antibiotic(s) and antiseptic, then inserted through a small imperceptible surgical access, symmetrically positioned, and snugly secured for predictable, natural results.  Procedures are accomplished in the office under local anesthesia or, if accompanied by other procedures, under general anesthesia.  Implant(s) are selected to match your facial bones and your desired result.  When you are numb, delicate plastic surgical techniques are incorporated to develop a precise pocket directly upon the surface of your mandible, the lower jaw bone.  This pocket lies beneath a layer of “periosteum,” the connective tissue membrane that adheres closely to skeletal surfaces.  Periosteum is carefully separated from your bone under direct vision to establish space for the implant.  Placing your implant beneath periosteum insures a measure of stability and camouflage, so your implant is not expected to move, and unlikely to be seen and/or felt.  Implant placement within the pocket is performed aseptically (to avoid infection), precisely for symmetry between right and left sides, and delicately to avoid injuring surrounding nerves, muscles, skin, and other structures.  Irrigation with antiseptic and confirmation of proper implant positioning is followed by skin edge approximation and closure in several layers for durability, and under magnification with surgical optics for the least visible scar.  Chin augmentation is often performed with other enhancements such as rhinoplasty or necklift.