Posts Tagged ‘chin augmentation’
Tuesday, June 11th, 2013
Q: Dr. Eppley, I was wondering if you could answer a quick question for me: Is there a way to perform a sliding genioplasty without having to cut the mentalis muscles? Is it possible to use an extraoral incision under the chin (if the patient didn’t care about small scars) to reduce damage to the underlying muscles of the lips? I am tired of hiding my face but I don’t think I’m brave enough to risk damaging the nerves or musculature of my lower face. How risky is this procedure?
A: Whether you go from inside the mouth or from below the chin, the mentalis muscle has to be cut. Even in a chin implant the muscle has to be cut. In skilled hands, a sliding genioplasty is a very safe and effective procedure with no long-term muscle or lip issues. The key is not whether the muscle is cut but if the surgeon knows how to put it back together.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, dr barry eppley, indianapolis, sliding genioplasty
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Friday, June 7th, 2013
Q: Dr. Eppley, I’m trying to achieve a more aethetically appealing face, by whatever means necessary. I’ve noticed my forehead protrudes in respect the level my eyes are at, making them look sunken and my face more masculine. I don’t believe it’s my bossing that sticks out, just my forehead in general, so i’m not sure how much of a result I would see with surgery. I’ve been told my nose is large, so I’m considering rhinoplasty as well. Additionally, my lips appear to almost ”hang off” my face. I know this isn’t your forte but do you believe jaw surgery could be a solution? In general, I was just wondering what procedures you would recommend. Thank you for your time and I look forward to hearing from you!
A: Thank you for sending your pictures. I have done some imaging predictions based on the one side profile that you sent. What I have done is a forehead reduction, rhinoplasty and chin augmentation . If you look carefully at those changes, the most dramatic effects come from the rhinoplasty and chin augmentation. The rhinoplasty is key because your forehead and brows look so pronounced because you have a very deep radix. (root of the nose). One of the key manuevers in your rhinoplasty is the buildup of the root of the nose. By doing so that makes the forehead less retrusive in appearance alone.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, dr barry eppley, forehead reduction, indianapolis, rhinoplasty
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Sunday, March 31st, 2013
Q: Dr. Eppley, many thanks for your email reply and I have attached some more pictures. Hope they are of the correct type – if you need better quality or closer views I can arrange that. As you can see I’ve taken photos of my profile many times and at varying body weights. The thinner I am the better my jawline looks, obviously, but I find it difficult to maintain the weight that allows this (roughly 50kg) – also I worry about when I get pregnant that I will look terrible with a big double chin.
My main concerns are that, from the front, my lower face looks chubby with jowls just to the right and left of my chin. I feel this makes me look really young but not in a good way!Like a chubby little girl! From a side(but not complete profile) view the jaw line gets hazy-looking about halfway along. In profile my chin just looks really weak which, to be honest, I wouldn’t mind so much but its the fact that this causes my neck structures to be poorly supported and therefore have a double chin. I also feel that my lower jaw is asymetrical and this can be seen from the front? Think that the left side of jaw is shorter making jowls worse on that side?
I have pushed my lower jaw out in some of the pics to get a view of what things might look like if I have a better jaw line/chin but obviously this gives me a horrible underbite and can’t walk around looking like that all day! But thought you might be interested to see the jawline I have in mind and I would hope for.
I included a pic of me at a lower weight to show you the effect of that as well….maybe I just need to knuckle down and lose the weight because currently I eat whatever I want and do NO EXERCISE at all…very bad I know!
Feel that my nose is quite fat looking at the lower portion from the front although I don’t have too much of an issue with the view in profile. Can something be done to make nose less bulbous at the end? This is definitely less of a concern for me the as
it’s my chin that I really hate and think about it pretty much every day and am self conscious about it.
Many thanks.
A: Thank you for sending your pictures. What they show and you demonstrate so well is that the chin/jawline is somewhat short. Lengthening the chin by jawline distraction produces a good improvement. This manuever demonstrates to me that a sliding genioplasty would be a better treatment choice than a chin implant. Moving the chin bone forward brings with it the the underlying neck musculature and, as a result, produces a better jawline/neck appearance. One may also consider submental liposuction with the chin advancement to ensure getting the best result possible. As for the jowl asymmetry, the chin bone would be advanced symmetrically and hopefully that will make an improvement in that concern as well.
As for the nose, that would require a straightforward tip rhinoplasty to thin the cartilages and make the tip less bulbous.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: chin augmentation, chin osteotomy, sliding genioplasty, tip rhinoplasty.com
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Wednesday, January 23rd, 2013
Q: Dr. Eppley, I had jaw augmentation and a little lipo in the neck area…It was performed 2 weeks ago today….I can’t move my bottom lip in a downward motion which means I can’t smile….I still have a great deal of swelling although significantly less…Is this nerve damage permanent or could the swelling have something to do with it.Your advice would be greatly appreciated as I am very nervous. Thank you. It was performed by a very reputable surgeon but none the less I now bad outcomes can happen to anyone.
A: What you have is weakness of the marginal mandibular nerve branch of the facial nerves. This tiny nerve branch, which supplies the depressor muscle of the lower lips, crosses over the jawline on the side of the chin. It is not really at risk from the jaw (chin) augmentation since that is down at the bone level which is deeper. It is at risk from liposuction of the jowls particularly if liposuction is done at or above the jawline which is exactly where the nerve runs. Nerve injury from liposuction , because it is a blunt instrument, does not cut the nerve but bruises it. This may make it weak for a period of time (unable to lower lip) but recovery almost always occur. Nerve recovery does not parallel swelling reduction, however, and usually takes much longer. In most cases llike yours, full functional nerve recovery can take up to three months or longer. Given that there is no other treatment, patience is all you can do for it.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, dr barry eppley, indianapolis, lower lip weakness, neck liposuctionj
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Friday, January 4th, 2013
Q: Dr. Eppley, I am interested in forehead augmentation and possibly rhinoplasty. I have put together a compilation of my head shots along with some of the “standard” head models. In short, I feel that I have a huge face and no skull. I would like to achieve a better balance between the two. So the procedures I was thinking of are 1) Forehead augmentation and 2) Skull Augmentation to the sides, up and back (if possible of course, sounds like a lot). I am also considering a rhinoplasty to reduce the width of my nose. Please see the attached compilation and let me know what you think. Thank you so much for a prompt response.
A: I have done some imaging based on what I see as the causes of your face:skull disproportion. Your forehead is sloped at a near 45 degree angle with no brow prominence. When combined with a long overprojecting nose and a short chin, your face looks out of proportion to your skull. By doing a forehead augmentation, shortening the nose and bring the chin forward with a central button implant, there is much better balance between your face and skull. I have attached some imaging to show what effects those procedures might have on your appearance. These imaging predictions are just a first pass on the procedures and more or less changes are possible.
Dr. Barry Eppley
indianapolis, Indiana
Tags: chin augmentation, dr barry eppley, forehead augmentation, indianapolis, rhinoplasty
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Friday, December 21st, 2012
Q: Dr. Eppley, I really wanted to advance my chin and make my jawline straighter. I know I will need a sliding genioplasty and perhaps bone cement along the sides of my jawline. I was wondering if what I had in mind is possible and have done my own before and after to show you whicih I have attached. I like how the part below my lip and above my chin comes out almost like the jaw was moved forward, along with the the extension of my chin and straightness of the middle part of my jawline. Is all of this possible ? I don’t want to use any kind of implant, just my bone and bone cement. Can you make a custom 3D implant mold and place bone cement in that instead of using an implant ?
A: What you are demonstrating is the classic change that would occur from a sliding genioplasty. There is no need for bone cement or 3D model fabrications to get there. The chin bone (not the jaw bone) is cut and moved forward and plated into position. While silicone synthetic implants can be made from a 3-D model you can not use bone cement to create an implant as it is too brittle.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, dr barry eppley, indianapolis, sliding genioplasty
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Monday, December 10th, 2012
Q: Dr. Eppley, I had two chin implants that had various problems so I opted for sliding genioplasty. For this surgery my surgeon drawn some sketches on my x-ray tracing which added 6 mm. I knew my prior implants didn't give vertical length and 6 mm looked fine and he explained about soft tissue draping that it would add some fullness too. I showed him examples of the chin I would like to have. And he said it’s possible. But now I am utterly frustrated as even after talking things through and showing him what I wanted I am stuck with how my chin looked like with an implant with very little added vertical length. Please let me know your thoughts. Should I ask for revision? When I told him my concerns, he said not more than 5-6 mm is possible with sliding genioplasty becaus
e that is what the metal plate allows.
A: My only comments are:
The step chin osteotomy plates go out to 10 to 12 mms, depending upon the manufacturer. I am not familiar with a 6mm advancement limitation by the fixation device. In some patients, there may be a bone thickness limitation for the amount of forward movement that can be achieved.
When measuring the chin bone for advancement by a sliding genioplasty, the soft tissue does not add any fullness. It moves in a 1:1 relationship with the bone. Therefore, for example, if you want the soft tissue chin point to move 10mms to get a desired look then move the bone 10mms.
Dr. Barry Eppley
Indianapolis, Indiana
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Tags: chin augmentation, dr barry eppley, indianapolis, sliding genioplasty
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Monday, October 29th, 2012
Q: Dr. Eppley, My brows and eyes give me a cold look and I’d like to have a softer image. I am consider getting brow reshaping, but what else can be done to improve my appearance. I have attached a front and profile picture to see what you think can be done.
A: Thank you for sending your photos. I would not disagree that your brow bone shape and promience do give your eyes a bit of a harder look. While the brow bones can be surgically reduced, there is always the tradeoff of a scalp scar to do it. That can be a precarious trade-off in men based on their hair pattern, density and potential hairline instability. I am niot ruling it out for you but I think there are other facial issues that I think would be equally, if not more effective, that can be done with no such trade-off. Your prominent nose and short chin create a significant amount of facial imbalance. Their alteration by reduction rhinoplasty and chin augmentation puts your face in better balance and would help to give your face less of a cold look. I have attached some imaging to see what you think of the nose and chin changes.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: brow reshaping, chin augmentation, dr barry eppley, indianapolis, rhinoplasty
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Monday, October 29th, 2012
Q: Dr. Eppley, I’m unhappy with my face. I think the horizontal projection is very poor and the jawline is weak. Just starting to look into options and I would be happy to hear any ideas you have. My first thought was that chin implants might be helpful. I’m hoping to create a face that Asian and white women will find very attractive and projects warmth while also commanding respect in a business setting. I have attached a profile picture for your thoughts.
A: I am not sure what Asian or Caucasian women would necessarily find attractive or what facial appearance projects warmth while commanding respect in a business setting. But in looking at your side view pictures, I would agree that your chin is weak and out of proportion to the rest of your face. Having a more proportionate chin would give your face better balance and is what I think you would give you an improved facial appearance that may be considered more attractive as well as casting an image of greater masculinity. I have done some imaging on your side picture to see if you agree. The chin augmentation, which could be done by either implant or a sliding genioplasty, would benefit by concomitant neck liposuction as well.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, chin implant, chin osteotomy, dr barry eppley, indianapolis
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Monday, September 3rd, 2012
Q: Dr. Eppley, I’m unhappy with my asymmetric face and would like to have a nose job and chin implant to correct it. Would it be possible to correct it with standard Medpor chin implants? Which chin implant it would suit to me better to correct it and can I get a view how would I look after these changes to my face.
A: Thank you for your inquiry and sending your pictures. I have done some imaging on your nose and chin. Your rhinoplasty is straightforward, meaning that tip shortening with narrowing and a little lift and dorsal line straightening with narrowing of the upper nose with osteotomies would be done. Your chin is severely short and I could argue that an implant is not the best choice given the limits of how much horizontal advancement can be obtained with off-the-shelf implants. (only up to 10mms) But I have imaged what I think the most that a chin implant can achieve. When it comes to chin implant type, there are advantages and disadvantages to either silicone or Medpor materials. While some surgeons and patients get focused on their theoretical biological differences, I have never found them to be distinctly different in that way. I am more interested in what styles and sizes of chin implants the various manufacturers offer. In your case, I would likely choose a two-piece square chin Medpor implant of 11mms horizontal projection.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: chin augmentation, dr barry eppley, indianapolis, rhinoplasty
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