Posts Tagged ‘chin implant’
Friday, May 3rd, 2013
Q: Dr. Eppley, for my chin and jaw angle implant surgery I have couple of questions. I had originally mentioned the idea of some liposuction below the Jaw line/ chin and wanted to see if you thought that was still an option( especially if it could be done through the chin implant incision.) Finally, any ideas of a realistic downtime from work? Would 3 weeks be enough to be off work and able to go back without looking extremely swollen? Also can the surgery be done under IV/ twilight sedation? Thanks again for your time. Thanks again
A: In answer to your questions:
1) Submental liposuction can certainly be done at the same time with access through the same incision as that of the chin implant.
2) The vast majority of the swelling from this type of surgery is from the jaw angles and you are correct to assume that 2 to 3 weeks is enough time for you to look normal, even though the final details of the result will take months to fully emerge.
3) This is not a procedure that is done under sedation anesthesia. Lifting the large masseter muscles off of the mandible is less than a pleasant experience to place the jaw angle implants. This is a procedure that requires general anesthesia to be done correctly.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: chin implant, dr barry eppley, indianapolis, jaw angle implants, submental liposuction
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Sunday, April 21st, 2013
Q: Dr. Eppley, I was wondering how much of an advancement in millimeters via either an implant or genioplasty to achieve a more masculine chin and does my deep groove effect the outcome. Thanks.
A: How much chin advancement any patient can obtain depends on their anatomy. For a sliding genioplasty it is usually
up to 12mms based on the front to back distance of the thickness of the chin bone. An implant can do more as it is based on how the implantg is fabricated, how much the soft tissue can stretch and the placement of the submental incision to place it. Increases in horizontal projections with chin implants can be done up to 15 to 18mms. In some cases, a coimbination of a sliding geniplasty with an implant overlay can be done with increases up to 20mms.
Any amount of chin advancement, no matter how it will done, does not change the labiomental sulcus and, in cases of significant advancement, will make it deeper. In a genioplasty the ‘step’ in the bone can be filled in to help preventing worsening the depth of the sulcus. In chin implants, the best simultaneous treatment would be fat injections placed directly beneath the sulcus.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: chin implant, dr barry eppley, indianapolis, sliding genioplasty
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Thursday, April 18th, 2013
Q: Dr. Eppley, My goals are increased horizontal projection of my chin( no vertical lengthening)and a more square chin. Jaw angles flared out with augmentation of the angle itself and of the ramus but not the body? ( not necessarily a drop down of the angle itself as I think the angle is low enough currently). Rhinoplasty to decrease the hump in the nose possibly decreasing the width of the bony part of the nose when viewed from the front and the tip refined somewhat( picture with red hat)( My morph( lateral view of my nose in the blue shirt) I admittedly got a bit crazy/unrealistic with the tip of the nose. Finally, liposuction below the lower jaw/chin area to get rid of the adipose tissue that has always been there no matter my weight( a good 10-15 mm in various spots under the jaw/chin when I do a pinch test.) Also, wondering if the chin implant can be placed through an existing scar on my chin from my childhood.( picture added of scar 20 mm long and 10 mm long in the 2nd aspect and around 3 mm of width to the actual scar line( the scar is basically a T shape) Attached are some before and after pictures that I’ve done in photoshop as what I’m kind of looking for in general terms. I don’t know if this is even possible / what would be proportional for my face, but thought I would include them as a rough reference since I’m not there in person currently. My overall goals are increased balance in my face as I think the upper 1/3 of my face/ head is much larger then the lower 1/3. Also, I’m looking to do this with IV/ twilight sedation and not general. I’ve had septoplasty (2004) and a hernia operation in the past with just iv sedation(+ spinal for the hernia sx) and prefer this option.
Thanks a lot.
A: Thank you for sending your pictures and doing the array of imaging. My review of the imaging matches fairly well with your goal descriptions and I would agree with much of it with the exception of a few minor variations.
For your chin you seek more horizontal projection, a more square shape in the frontal view and no change in its vertical length That would be possible using a square silicone chin implant, probably of at least 7mm to 9mms in thickness placed through a submental incision. It would not be wise to use your existing scar as it is too small, would become more prominent as the chin is pushed forward and would dive through the mentalis muscle in the process. A scar revision can be done on it but it would not be used to place the implant.
Your jaw angles show width expansion, a sharpening of the angles and no vertical lengthening. That could be accomplised by a 9mms silicone lateral augmentation implant placed directly over the existing angles.
The only comments about potential results with these implants is that the angularity of them (point of the angles and sharpness of the chin corner) may or may not be as sharp/pronounced as you have shown. The other issue is the continuity or smoothness of the jawline from the chin back to the angle. While the ends of a square chin and jaw angle implants will overlap, these overlapping areas are not as thick as the other parts of the implants. This it is not clear that the jawline will be as perfectly smooth from front to back as you have imaged.
The nose can be changed through an open rhinoplasty with a hump reduction and tip narrowing and some mild lift. I think those results are very achieveable.
Lastly, this collection of combined facial structura procedures can be done very well under just IV sedation. These are operations that are best performed under general anesthetic to get the best result.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: chin implant, dr barry eppley, indianapolis, jaw angle implants, rhinoplasty
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Tuesday, April 2nd, 2013
Q: Dr. Eppley,I am a 27 year-old man currently looking for the best surgeon to carry out jawline and perhaps chin augmentation. I would love to get rod
of this beard which I sue to camouflage my weak lower jaw. I have added you on Skype for a consult and have attached some pictures for your review.
A: I have done some imaging on your pictures. Yo do have a very short chin and high jaw angles. I don’t think a chin implant alone would suffice for the change that I have imaged. The concept of a sliding genioplasty with an overlay small square chin implant can create a 12 to 13mms of horizontal increase and add more squareness to your chin from the front view. Your jaw angles need vertical lengthening only with a minimal horizontal increase. All put together this should create a dramatic change in the jawline that will make you be able to dispense with the beard if you so desire.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implant, dr barry eppley, indianapolis, jaw angle implants, jawline enhancement
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Thursday, March 28th, 2013
Q: Dr. Eppley, I like what I see, much more “chiseled” appearing. Would it be unnecessary to or insensible to increase the length of my chin to make it sort of protruding? I’ve always found that to be appealing/masculine. I know people get chin reductions to avoid that, but I’ve always liked that. If not, I feel that I see some flaw in my chin/jaw line that stands out to me. I’ve always wanted a stronger jaw/chin, maybe overly strong, beyond typical. Maybe it is my jaw? Would you recommend a possible jaw implant along with the rhinoplasty and chin implant? Do you think this would match my desired traits? I desire an angular sort of jaw, with a square appearing and strong chin, and my nose looks great after, but is there a way that it could be made that you couldn’t see the bottom of my nose? Its always made me self conscious that the bottom of my nose has been visible when i am looking at someone. I am sorry I’m asking so much, I just want to make sure that I am 100% pleased with the procedure and I want to get as much done at once as possible by the same person and you
seem to know exactly what I want.
A: When it comes to vertical lengthening of the chin, that can not be done with an implant by more than few millilmeters. It would require a chin osteotomy or a custom chin implant to do that which, although can be done, adds to the cost of the procedure. I would just use a square chin implant of 9mms augmentation and position low on the chin bone so that is some degree of vertical lengthening. I believe that will more than suffice.
The trifecta of jaw angle implants and a chin augmentation are the best way to create a chiseled jawline. The key question in jaw angle implants is whether they should just be of the lateral augmentation type (just adds with to the jaw angle) or whether they should be of the vertical lengthening type with variable amounts of width addition. What most men who seek the chiseled jawline look need is the latter, some vertical lengthening and width addition to create a sharper and more defined jaw angle at the back of the jaw.
Your nose is slightly over rotated (tip up too high). The tip could be rotated downard to some degree using septal extension and tip only grafts during your rhinoplasty.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: chin implant, chiseled jawline, dr barry eppley, indianapolis, jaw angle implants, rhinoplasty
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Wednesday, January 16th, 2013
Q: Dr. Eppley, I would like to know which one of the two approaches for chin implant surgery is better, intraoral or submental incision? How do you avoid cutting the branch of the facial nerve. When you do the submental incision and how likely is it to injure this nerve by the submental incision?
A: There are advantages and dusadvantages to each chin implant approach. Neither one is necessarily ‘better’. Both are acceptable chin implant approaches and produce similar results if technically done well. The submental approach avoids the intraoral incision and the need for disinsertion of the mentalis muscle from the bone when coming from above and that may make the recovery process a little bit easier. The submental incision should have virtually no risk of injuring the marginal mandibular branch of the facial nerve. The course of that nerve lies way to the side of where the submental incision is and is in a much more superficial tissue plane than the subperiosteal approach to the chin bone.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implant, dr barry eppley, indianapolis
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Monday, December 10th, 2012
Q: Dr. Eppley, I had previously two chin implants which failed to give the length I desired. So I had an sliding genioplasty two months back with implant removal. As the swelling has gone down I look almost same as I did with implant. My surgeon said he advanced my chin 6 mm downwards and 5 mm horizontally. Is it the maximum advancement possible with sliding genioplasty? Your wise thoughts will be very much appreciated.
A: I have several thoughts about your chin surgery history and your question. Did you and your surgeon have a good understanding before surgery using computer imaging as to your desired chin goals? Changing the chin is one of the most predictable of all aesthetic structural facial procedures as the bone/implant change is 1:1 with the overlying soft tissues. It seems very pecular to me that you could have had three chin surgeries, none of them with large chin changes, and still end up inadequate. The bony genioplast
y movement of 5mms horizontally is not very significant and, regardless of whatever size chin implant was in before, I am not surprised that you look no different now. You essentially swapped out the change provided by an implant for that of an osteotomy but no more. (other than some vertical increase) When one trades out an implant for an osteotomy it is because the osteotomy can make dimensional changes that an implant can not. While chin implants are not capable of providing more than a few millimeters of vertical height increase, they are capable of 9 to 10mms of horizontal lengthening. The amount that a bony chin can be advanced is based on the thickness of the bone but in most cases the amount of lengthening can be 10 to 12mms as the back edge of the downfractured chin segment touches the front edge of the intact upper chin bone.
Dr. Barry Eppley
Indianapolis, Indiana
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Tags: chin implant, dr barry eppley, indianapolis, sliding genioplasty
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Sunday, December 9th, 2012
Q: Dr. Eppley, I am a 32 year-old male and I would like a well-defined jawline. I have attached some pictures for your thoughts.
A: Thank you for your inquiry. When it comes to improving the 'jawline' that could mean various things to different people. Fundamentally it comes down to whether one wants the front of their jawline (chin), the back of their jawline (jaw angles) or both improved. Those distinctions are obviously important as they involve different procedures.
In looking at your photos, an obvious horizontal chin deficiency exists. That could be significantly improved by either a chin implant or a buy zithromax online
leyplasticsurgery.com/chin.html”>sliding genioplasty. There are advantages and disadvantages to either approach and, based on what I see so far, I would lean towards a sliding genioplasty which would advance your chin up to 12mms but would also narrow it a bit in the frontal view which may be aesthetically advantageous for you. I have attached some prediction imaging of that potential result from the side view. It is not clear, based on just one photo, that augmentation of your jaw angles would help improve your jawline. I have done some imaging on this grainy frntal photo but it is questionably helpful. Better photos would ultimately be needed to clarify this issue.
Dr. Barry Eppley
Indianapolis, Indiana
zp8497586rq
Tags: chin implant, dr barry eppley, indianapolis, jawline enhancment, sliding genioplasty
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Wednesday, December 5th, 2012
Q: Dr. Eppley, First off just to inform you that I have been dealing with this since I was 19 yrs old, I am 46 yeras old now. I was born with a very weak chin. I never told anyone and always wondered why I took horrible pictures. Took me many years to figure it out that my jaw was not there. Been ripped off as one doc did needles in my neck and liposuction in 1991 and still had a turkey neck. Then I had a chin implant in 1996 and still had a turkeyneck after. I am a police officer and when people want a pic with a police officer I turn them down. I hate this. Is there any help? I do weight train & cardio but nothing changes my neck. I just entered on the computer about weak jaw for men and your site came up.
A: Thank you for your inquiry and sh
aring your very personal story. Until I see some pictures of you it is hard to know whether you have a very underdeveloped lower jaw although your description sounds very much like that is so since you have had this issue since you were very young. Your prior chin implant may not have been successful because the volumetric dimensions that it added were way inadequate, not that the concept of it was wrong. Significantly lengthening of the jawline and chin will also provide improvement in the turkeyneck appearance as the jawline becomes longer, a neck angle becomes more apparent. Please send me a front and side view of your face for my further assessment.
Dr. Barry Eppley
Indianapolis, Indiana
zp8497586rq
Tags: chin implant, dr barry eppley, indianapolis, jawline enhancement
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Friday, November 30th, 2012
Q: Dr. Eppley, I think I may have screws up my chuin surgery. I was washing my face and was pushing really hard on my chin but didn't know because it is numb and then something felt different…on the right the implant was in a different location. Then I protruded my mandible forward and it only felt tight on the left of my chin, not on both sides of it anymore. And then I palpated my implant and on the right the implant is completely on the outside of my mandible and on the left it is under it. It is bad. Now it is in a lot of pain. I tried putting it back in place but it is of no use. I will just injure myself. Now the incident is giving me a lot of pain: my whole chin and the new location of the implant. Before this happened I called about having you call in more pain medication to my pharmacy and I mentioned a painful tumor-like lump on the left side of my mandible. It is hard like bone, and round, and inferior to the bone as well as lateral to it. My pain includes pain in this area. However, the area felt different to the touch than other areas. Now, after what I have caused to happen with the implant, I cannot assess it. It is still painful to the touch, although the lump seems smaller and less obvious. It was causing my chin to look shifted to the left, because the right of my chin was flat and the left protruded where the lump was/is. Where the implant was feels like a dent in the bone of my mandible and somewhat looks like one. Now that the implant, out of place, adds width to the right side, my chin looks more centered than before, where it looked shifted to the left. I am also sending a picture of the area where the fat was inserted, just checking if everything looks normal. Both of the ar
eas containing the transplanted fat feel to the touch like I am touching like hard rubbery rubber implants. Just want to know if everything's normal. Thanks.
A: Thank you for the follow-up and sending your pictures. Let me share with some basic concepts about the recovery process from your chin osteotomy/implant and fat injection surgery. It takes a minimum of at least 6 weeks and closer to 3 months to see the final result. It is very normal to have everything that you are feeling and showing at this point, which is very early at just 9 days after your procedure. Besides the swelling, numbness and bruising, every chin osteotomy patient at this point will have hard lumps at the end of the osteotomy cuts on the side of the jawline. That is what you are seeing on your left side and I would not consider that abnormal at this point. While it is possible that could be a malpositioned end of the implant overlying the osteotomy site on that side, it is just as likely that is swelling and a collection of blood from the surgery. I would be a lot more concerned about that issue if this was 4 or 6 weeks but not yet at 9 days out from surgery. I also doubt that you could have malpositioned the implant by rubbing on the outside. The bone and the implant are secured in placed by plates and screws so it would be very hard to displace it. The fat injections into the nasolabial folds will feel and look exactly how they do at this point and that is perfectly normal. It will take 4 to 6 weeks for them to smooth out, blend in and feel normal.
Hang in there as it is still very early in your recovery process.
Dr. Barry Eppley
Indianapolis, Indiana
zp8497586rq
Tags: chin implant, chin osteootmy, chin surgery recovery, dr barry eppley, fat injections, indianapolis
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