Q: Dr. Eppley, I had a custom jawline implant (done by Implantech) placed last year, but there are some areas that haven’t been addressed adequately. Assuming that the design file is still available, can I just check if it would be possible to modify the previous implant design? Also, would it end up costing as much as getting a brand new custom implant made, or will the cost of modification be lower?
Additionally, I’m looking to get my philtrum augmented. Would any existing implant work (Peri-pyriform?), or should I consider fat grafting?
A: This is not the first time I have had a patient inquiry about changing a custom jawline implant to a new or tweaked design. I can assure you that your original design file is still available and the previous jawline implant design can be modified. There is some reduction in a new implant design cost fee which is about 15% from the original pricing. (as per the manufacturer) The other good news is that replacing an existing jawline implant with a new one is substantially easier than the first time with a very quick recovery.
I believe when you refer to philtral augmentation, you mean paranasal/upper lip augmentation. That is what is illustrated in the link you have provided. True philtral augmentation is philtral column augmentation done by placing cartilage grafts or small implants in the philtral columns of the upper lip right under the skin to give enhanced ridge lines. There are advantages and disadvantages to either injected fat or placing implants along the nasal base. (paranasal-premaxillary region) In general, implants are going to give a more assured and permanent augmentation effect.
Dr. Barry Eppley