Posts Tagged ‘chin implants’
Monday, February 6th, 2012
Q: Dr. Eppley, I want to have a chin implant, I want to ask you is a chin implant with a screw holding it into position a must so that it won’t move? One doctor said screw is not necessary as she said you can extend anteriorly more than 1 cm it and it depends on how the doctor carves out the implant so it won’t move place. Is what she said true and effective?
A: How any surgeon secures their facial implants is a matter of personal preference and experience. I prefer to screw all facial implants into place when possible to get the best aesthetic result (assured position) and never have to worry about them every moving or sliding from where I want them. That is my personal preference and has served me and my patients well over the years. Just because other surgeons make not choose that technique of implant fixation, or any fixation at all, does not make them wrong. That is obviously what works for them.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implant fixation, chin implants, dr barry eppley, indianapolis
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Wednesday, December 28th, 2011
Q:Hi Dr. Eppley. I will be 17 years old next summer. I’m looking to get some implants as I get a little older. Is there any way of creating a custom jaw/chin implant? If so, would this cost extra? If so, how much? Much appreciated. Also, what is the minimum age requirement if one wanted to get some facial implants? I’d like as much information as possible please. Much appreciated.
A: The timing of chin and jaw implants is based on two factors; the degree of jaw deficiency, one’s bite or occlusion and the near completion of jaw growth. At this age you want to be sure that you do not have a correctable malocclusion by a combined orthodontic and orthognathic surgery approach. If not, then chin and/or jaw angle implants may be appropriate. I certainly would not perform that surgery before the age 18 when jaw growth is closer to being complete in a male. Custom chin and jaw implants can be done and I do them on a regular basis. But whether they are really needed and offer any advantage over stock preformed implants must be determined on a regular basis. It is hard to give any reasonably accurate pricing when I don’t know whether one needs just a chin implant or whether one needs a combined chin and jaw angle implants for total jawline enhancement. In either case, custom implants will double the price of the surgery due to the need for special design and fabrication. For this reason, one has to have a very compelling anatomic need to justify the expense of a custom facial implant process.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implants, dr barry eppley, indianapolis, jaw implants
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Wednesday, August 17th, 2011
Q: Dr. Eppley, I would like to achieve a radical but natural look. My main problem is that I was born with a bad bone structure. I want a bigger chin, jaw implants to make my face more square, high cheekbones (but natural i´d like to know if fat grafting would be an option), and I see some irregulaties in the form of my forehead and i like to look uniform. Is it possible to correct it with a natural and safe filler? I also think that some liposuction under my chin will help me to create a better facial profile. I have attached some pictures of myself for imaging these changes. Thank you so much.
A: In reviewing your pictures I see that the deficient bone structure is really isolated to the short lower jaw/chin and a forehead that slopes backward. I would agree that a chin augmentation using a square chin implant, and jaw angle implants that both widen and lower the angle would compensate nicely for the lower facial bone deficiency. The jawline improvement would be enhanced by submental and neck liposuction. From a cheek standpoint you can certainly use fat injections. Another fat alternative is to remove part of the buccal fat pads and use this as a ‘cheek implant’, serving the dual purpose of malar augmentation and some submalar contouring. Fat injections could also be used as a forehead filler as well for any irregularities. The attached imaging illustrates some of these potential facial reshaping changes.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: buccal fat, chin implants, dr barry eppley, facial reshaping, indianapolis
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Saturday, August 6th, 2011
Q: Dr. Eppley, I am committed to undergoing chin augmentation with an implant but I am a little anxious. I just have a few questions. What do you see as the risks involved with a chin implant procedure, if any? Do your predictive photos mirror actual results? Thanks for taking the time to answer my nervous questions.
A: In answer to your presurgical jitters:
1) There are always some risks with any surgery and chin implant augmentation is no exception. Fortunately those risks with chin implants are few and very low. The ones that I have observed are infection (1% to 2%) and asymmetry of the wings of the implant. (2% to 3%) Both are very correctable, albeit with a revisional surgery. There is always the risk of too little or too much chin augmentation with an improper size implant but that is not a very common problem in my experience.
2) Computer imaging is an estimate and not an exact predictor of the final outcome from any plastic surgery procedure. Its predictive ability varies based on the type of procedure being performed. Of all the facial cosmetic procedures, chin augmentation is one of the more accurate in terms of predicting the outcome as it is a profile or silhouette facial feature.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, chin implants, dr barry eppley, indianapolis
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Monday, August 1st, 2011
Q: Dr. Eppley I am 34 years old and in the past several years I have noticed quite a lot of sagging in my mid and lower face along with volume loss. Cheeks have gravitated downward, neck sagging and my eyes have hollows under and around them. I see much of the same in my mother. I have researched many plastic surgeons this past year and have heard only great things about you online! I am most concerned with sagging in my lower face, neck and around cheeks. I also would maybe like to add some volume to lips especially from a profile view. And one more thing, my ear lobes tore several years ago from scabbing due to hypersensitivity to earrings so I would like to have ear lobes repaired as well.
A: I have taken a careful look at the pictures you have sent me. As you know you are fairly young for any major procedures and you really don’t need anything too drastic. But I can see your concerns about having an overall tired appearance. There are several things I might consider for some structural improvement. These would be the following: small cheek implants to lift the midface and fill out some hollowing, small chin implant for more chin projection and to improve the jawline, and liposuction of the jowl and neck for a little contouring and skin tightening. I think if you can just ‘slenderize’ your face a bit and give it some more structure or angularity, it will look more youthful and rested. You most certainly don’t need anything done around your eye area.
As you know, you already have excellent lips with good vermilion show so increasing their size is a matter of adding some more volume. This could be done with fat injections as you can take advantage of a surgical opportunity since this is not a traditional office procedure. Obviously the earlobe repair can be done at the same time with any of the aforementioned procedures.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, chin implants, dr barry eppley, indianapolis, structural facial surgery
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Tuesday, July 5th, 2011
Q: Dear Dr. Eppley, I recently read, that a revision on a chin implant that has been inserted through an intraoral incision, can lead to distortion of the chin muscle because this muscle would be cut through twice. I don´t have a chin implant, but porex cheek implants (inserted through an intraoral incision) that need to be shaved down on the left side. Now I would like to know if an intraoral performed cheek implant surgery also involves cutting through a muscle what eventually could lead to distortion of the soft tissue if this muscle is cut through twice.Thank you in advance for your reply!
A: When it comes to surgical access in the face for the placement of implants, they must be placed down at the bone level below the periosteum. This always requires cutting through attached muscle to get to the proper placement level. But there are significant differences between the lower jaw (mandible) and the rest of the face. The lower jaw is the only bone of the face that actually moves, the rest of the facial bones are fixed. This makes for significantly different types of muscular attachments.
The mentalis muscle of the lower jaw, while having no function in its opening and closing, covers the chin bone and affects the lower lip and soft tissue movements. When it becomes detached or scarred, one can develop lower lip and chin soft tissue sagging. While good soft tissue closure will avoid this problem it is always a risk. While there is nothing wrong with secondary intraoral chin surgery, the upper attachments of the mentalis muscle are being severed and reattached twice. This does increase the potential for secondary mentalis muscle problems.
The intraoral placement of cheek implants does not cut through any muscles of jaw motion or those responsible for any soft tissue support. There are no risks, therefore, for muscle scarring that would affect any facial function or appearance. The muscle issues of intraoral chin implant surgery do not apply to intraoral cheek implant surgery.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek implants, chin implants, dr barry eppley, indianapolis
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Wednesday, June 8th, 2011
Q: I am interested in getting chin and jaw angle implants. I would like the chin implant to be lengthened (to the most extent) and squared (to the most extent) being in the category of the latest style available on the market. The jawline height should be lengthened and widened to its proportionate maximum possibly by having a “wrap around” implant and/or separated combination of implants. Do the latest style chin implants stating the above written factors of width and length fit the “wrap around” implant or separate implants more accordantly? Thank You.
A: In answer to your questions about chin and jaw angle implants, here is the following dimensions:
Square Chin implant (Style 2 Terino), Implantech = 6.5mm anterior projection in the middle, 10mm projection on the square portion (transition corner) of the implant, 9cms long (4.5 cms back from the middle on each side)
or
RZ Extended Square Chin, Medpor = 7mm in anterior projection, 11mm projection on the square portion of the implant. Because of the central connector, the implant can be expanded and made more square which also allows for the creation of central cleft
RZ Mandibular Angle Implants, Medpor = 11mm width expansion, 10 mm vertical elongation
These three implants must be put together to create a ‘wraparound effect’ but there will be a depression between the two along the jawline because their edges are feathered where they come together. They were never made to be used to create a completely smooth wrap around jawline effect. What you may really be searching for is a custom one piece wrap-around jawline implant that can be made to almost any shape and dimension.
Dr. Barry Eppley
Indianapolis Indiana
Tags: chin implants, custom jawline implants, dr barry eppley, indianapolis, jaw angle implants, jawline implants
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Friday, May 20th, 2011
Q: I am thinking about getting numerous facial procedures and I have a few questions. I am wondering if getting a chin implant will stop hair growth on my chin? Whatever I have done I want a natural look, will too much facial surgery ruin this or make me look unnatural? Last question,what are some alternatives to cheek implants?
A: A chin implant will not stop beard growth on the chin. It is put in through an incision under the chin so it is very far away from the hair follicles of the chin skin.
Getting a natural result in facial surgery is based on doing whatever procedures are done in balance with the rest of the face and not overdoing any one procedure. Facial surgery, whether it is a rhinoplasty, chin implant or forehead recontouring, is making the structural change to look ike it belongs to the rest of the face.
The only alternative to cheek implants is fat injections. While I think cheek implants and their numerous styles and sizes offer more versatility for cheek changes, fat injections can definitely add volume to the cheek and submalar (below the cheek) areas. With today’s more concentrated methods of fat preparation, fat injections to the face also work better in terms of maintaining volume to the injected facial area.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek implants, chin implants, dr barry eppley, fat injections to the cheeks, indianapolis
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Sunday, April 17th, 2011
Q: While I don’t think that I am bad looking, I feel that my jaw line is weak and small. My receding chin greatly distracts from my features and I am hoping a jaw and chin augmentation can help balance my lower face and give me a stronger, more masculine appearance. Ideally I would like to substantially increase my chin size horizontally, to or past my lower lip when viewed in profile as well as add vertical length as my chin is rather short. I also desire to add horizontal width and volume as well as increased vertical length when viewed from the front, or in other words a more “squared” appearance. Along with my pictures, I’ve included a rough depiction of what I am trying to achieve. The altered versions are a “goal” and perhaps you can tell me if they are realistic or not. The problem is I realize extending my chin out this far requires substantially augmentation (probably around 12-15 mm) and don’t really know if my goals are realistic. I’ve been researching your website and understand you do chin osteotomy in conjunction with chin implants. Would this be a possibility? If so are there greater risks in terms of potential nerve damage and bone resorption? Also, with such an invasive surgery, are there any long term complications after say a decade or more?
A: Your own predictive computer imaging is greatly helpful and shows exactly what you want to achieve. I could not have the done the imaging any better myself. Because you desire both horizontal and vertical chin lengthening and are a very young man, I would recommend a chin osteotomy which does a better job of such combined dimensional changes. The chin can probably be advanced about 12mms or so and that should be enough to get that look. The chin can become more squared with an osteotomy by splitting the downfractured chin bone and expanding it apart to create more width. As you mentioned, an implant can also be added to the front of the chin osteotomy to create the same effect. I would have to see intraoperatively which would work the best.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implants, chin osteotomy, dr barry eppley, genioplasty, indianapolis, plastic surgery of the chin
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Wednesday, April 13th, 2011
Q: Hello Dr. Eppley, I am interested in having a stronger structured jawline. I have been wanting this and am now prepared to have this done. I am tired of seeing a round fat face and with your expertise I think I can get the sculpted jawine that I have always desired. Here are some pics of myself and pics of jawlines that I want to look like. I think my jawline needs to be built up with a chin and jaw angle implants. Let me know what you think.
A:Thank you for sending your pictures. I have reviewed them and done some realistic computer imaging. My comments are as follows:
1) A big reality check is needed here. You can not get to or look like any of those examples. You have a completely different anatomy and skin and fat thickness of your face. While an admirable goal, it is not realistic. You can be improved and maybe end up about halfway between where you are now and those examples. All I can do is take what you have and make it more defined as much as possible.
2) A square chin implant will help the front of the jaw. Your chin needs to come forward and down to become the leading point of your face.
3) You need aggressive neck and side of the face liposuction with removal of your buccal fat pads. As much facial defatting needs to be done as possible.
4) I do not think that jaw angle implants will help you. You don’t need a wide lower jaw in the back. It is plenty wide, you need better definition of what you already have. Jaw angle implants will just make your face look fatter with no better definition.
Dr. Barry Eppley
Indianapolis Indiana
Tags: chin implants, jaw angle implants, jawline enhancement, jawline sculpting, plastic surgery of the jawline
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