A retrospective study of 480 Silastic chin implants is summarized and analyzed. The surgeon's own variations on the operative procedure are detailed, including the staging of the simultaneous nose-chin operation in which the chin work is started first, with a temporary interval for hump removal, followed by termination of the chin work and a return to the nose operation. A variation in the handling of the Silastic implant is described in which parallel incisions are made on its inner side to avoid dead space and undesired tension. The results of the 480 cases are presented. The overall complications rate was 2.3%, though the total percentage of implants removed was only 1.46.