Posts Tagged ‘chin reduction’
Tuesday, December 13th, 2011
Q: Dear Dr. Eppley, I consulted with a board-certified plastic surgeon who says he can round the corners of my chin and reduce about 5mms of projection without any ptosis or deformity. I have seen his before and after pictures and they are stunning. Best I’ve seen. Should I still be concerned about sagging. Also he wants to put me on a course of antibiotics, steroids and put a drainage tube in my chin to make sure no fluid collects for several days. What are your thoughts?
A: There is no chin reduction procedure of any significance in which the risk of soft tissue sagging does not exist. By definition when you make the supporting bone structure smaller, you have an excess of overlying soft tissue. With proper soft tissue management and suspension this potential concern can be avoided whether it is done from an intraoral or submental approach. The use of antibiotics and steroids are standard practice. The use of a drain is surgeon’s preference. It is not something that I have ever used for any chin procedure but I know there are some surgeons that do.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin reduction, dr barry eppley, indianapolis, ptosis after chin reduction
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Wednesday, November 30th, 2011
Q: Dr. Eppley, I am possibly going to have a chin reduction. Here is my serious concerns. I have a very thin face with hollow cheeks. My forehead is large and my chin is small. The problem is I have a projected or jutted out chin which is very pointy, especially when I smile. I have a very strong jaw line, and I just want to to get rid of the witch’s chin look but keep the exact same frontal look. I cannot afford to have my chin shortened. I want a softer look, but I am terrified that I am in for serious dissapointment. If I did this, I would want to do the submental approach and the burring teqnique because I don’t have a long chin. It seems safer, and by your articles it seems I may be correct. I want a softer, more feminine look without making my face look any thinner, and the projection gone. Is this possible?
A: Thank you for sending your inquiry and your pictures. I would take a slightly different approach to your chin. In the frontal view your chin is very square for a female and it needs tubercle reduction (side chin reduction) to soften it. From the side view, it needs some slight horizontal reduction and soft tissue tightening. I would not do any vertical length reduction. You need the length to fit the rest of your face.
This chin reduction procedure is best done, as you have mentioned, from the submental approach to manage the excess soft tissues that will result.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin reduction, chin reshaping, dr barry eppley, indianapolis
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Sunday, September 18th, 2011
Q: Dr. Eppley, The problem with my face is it’s very skinny when I don’t smile. When I smile I have the biggest fattest face ever! I have these fat pockets around my nose. And instead of a smile I look like I’m sneering. I was in an auto accident and it caused nerve damage to my left lip. I want to fix my smile so its even again and you can see more of my teeth. I also have a brow that I hate and would like to get rid of. I also would like some work done on my chin because I hate the way that looks. And also when I smile I have “jowls” and I’d like to get rid of those and my double chin. My double chin is hereditary and being tall and skinny this looks very strange. I would also like to get a nose job because I have my fathers nose and I think it looks very masculine. Overall what I am trying to achieve is a slimmer face, with more feminine features and a better more applying smile. I don’t feel like my face goes with my personality, and how I feel. Also anything else you see that needs to be done please let me know.
A: Thank you for sending your pictures. In looking at your face and reading your objectives I would consider the following procedures. A rhinoplasty is needed to make your nose thinner and less wide, particularly in the tip. I would also recommend buccal (cheek) fat pad removal (subtotal) and small cannula liposuction of the fullness above the nasolabial (lip-cheek) grooves. A lip lift (vermilion advancement) done with differential skin removal (left greater than the right) will help with better lip symmetry and overall fullness. A submental chin reduction is needed to decrease the amount of chin prominence and protrusion. Liposuction can be done in the neck and jowls to remove fat in these areas.
Unfortunately, I can only do limited computer imaging because your pictures are inadequate. Smiling photos make a lot of facial feature distortion.
You mentioned a dislike for your brows but I am uncertain what specifically you do not like about them. Until I know more, I can not make any recommendations on whether they can or cannot be favorably changed.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin reduction, dr barry eppley, indianapolis, lip lift, neck liposuction, rhinoplasty
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Wednesday, July 13th, 2011
Q: Dr. Eppley, I am Asian and interested in making my face more narrow. It is too wide in the cheek area. I also think my chin is too long and would look better if it was shorter. I woud like my face to be more oval and not so wide and square. Do you think cheek and chin reduction will achieve what I want? I have attached a picture for you to see my face from the front and show me what the changes would look like. Thanks!
A:I have done some imaging based on the single photo that you have sent me. It is a partial smiling photo so it is not ideal to use but it is acceptable to give you a general idea of the proposed changes. This predictive image is based on the following two procedures:
1) Cheek Reduction with osteotomies at the zygomatic body (front) and the temporal end of the zygomatic arch. (back) Your frontal facial photo shows a wide or bowed zygomatic arch from the cheek on backwards. This is best treated by total zygomatic arch narrowing as opposed to zygomatic body reduction. One would need a submental (vertex) x-ray before surgery to look at the extent of the bowing and determine how change (inward movement) of it could be done.
2) The chin reduction is a vertical shortening which is what I think you mean by chin reduction. I have no side view of your chin so I can not comment on any horizontal issues.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek reduction, chin reduction, dr barry eppley, indianapolis
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Sunday, June 5th, 2011
Q: I am interested in doing a ” Brow ridge reduction “, at least that is what I think it is. Also I would like a chin reduction. So my questions are; Are these types of surgeriess even possible? How far in advance do I have to schedule them? Have you ever done similar work to this? I have attached some pictures for you to see what I mean. Sorry as they are not the best quality.
A: Thank you for sending your pictures. Your requests for brow bone and chin reduction surgery is not uncommon and these are established procedures. I am very familiar with doing them and get requests for them all the time. Brow bone reduction (technically frontal sinus reduction since the brow bones are largely sinus cavities not solid bone) is done through a scalp incision. The outer table of the frontal sinus is removed and set back which makes the brow bone less prominent. It is a very effective surgery and the only significant issue in men (which are by far those who request the procedure) is the need for a scalp incision and the resultant fine line scar in the scalp to access the forehead and brow areas. Chin reduction surgery is done different ways based on which dimension of the chin one wants to shorten. If it is a vertical chin shortening that is done by an intraoral osteotomy and bony wedge resection. If both a horizontal and a vertical chin reduction is needed that is usually done by a submental (under the chin) incisional approach and the bone is burred down and the soft tissues shortened and tightened to the smaller bone.
This will give you a general overview of your requests. Both surgeries are possible and are part of cosmetic craniofacial reshaping surgery.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: brow bone reduction, chin reduction, cosmetic craniofacial surgery, dr barry eppley, indianapolis
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Sunday, May 29th, 2011
Q: Hi there, I have researched a tremendous amount on the internet to find what I think I need. Although I am from the UK I am willing to travel to you for good results as you are the only surgeon that has a wide range of procedures I feel I need for my long face. I have had prior surgery to my face including chin reduction and fat transfer to my cheeks. However it’s my facial skeleton I feel that just still does not look right. My eyebrows are hooked which I see you do brow reduction which you may recommend but its the whole chin jaw nose balance I am looking for improvement. I constantly am compared to the actress Sarah Jessica Parker which I hate! So you can sort of understand my facial faults. I am looking for improvement in my facial structure and to achieve better looking eyes. Many Thanks and looking forward to hearing from you.
A: While I will obviously need to see some pictures of your face, the long face look is not uncommon. There are certain features to it that create that look besides the fact that the vertical length of the face is measurably long. Often the face is thin and skeletonized with a prominent chin and a long and narrow nose. This is undoubtably why you have had a chin reduction and cheek augmentation to try and create a counteracting effect. While this has probably been somewhat helpful, those procedures alone may not create enough of an effect. Additional procedures to consider would be rhinoplasty, brow bone reduction, jaw angle augmentation and possibly further efforts at chin reduction.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin reduction, dr barry eppley, indianapolis, ja angle augmentation, plastic surgery for the long face, rhinoplasty
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Friday, March 25th, 2011
Q: My chin is too big and I need it reduced. What is the cost of chin shaving surgery?
A: Thank you for your inquiry. When one mentions ‘chin shaving’, they may really need a submentoplasty with chin burring reduction or they may really need a chin reduction via an osteotomy. It depends on their chin problem as the approach for chin reduction can differ based on the size and shape of their chin bone and the surrounding chin and submental soft tissues. Each method of chin reduction also differs in cost. Therefore, before providing a surgical fee quote please forward to me some photographs of your chin and what specific dimensional changes you want to see.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin reduction, dr barry eppley, indianapolis, plastic surgery of the chin
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Sunday, February 27th, 2011
Q: For most of my life I have considered myself ugly. I avoid having pictures taken and I most certainly don’t look at them if they have to be taken. I have a total lack of confidence and this has definitely poses problems in my personal relationships. I don’t know what it is about my face but it just doesn’t look right. I am only 29 but I look much older. My eye area looks droopy and old and may face looks thin and distorted. I have attached some pictures for you to see and review. What would you recommend to help me look better ?
A: When someone doesn’t like their face, particularly at a young age, this indicates that the problems are with how it is put together (structural components) not that it is has early aging. This means the underlying structures that make up the shape and highlights of the face which are largely bone and cartilage. In reviewing your pictures, I can see that your face has unbalanced structures which include low hanging brows, a broad and prominent nose, hollow cheeks, and a wide and long chin. The combination of these features creates an overall facial look that you do not like. Procedures such as an endoscopic browlift, rhinoplasty, cheek implants and chin reduction collectively would make a major change in how your face looks. It would lend a softer and more youthful due to a better balance of your facial features. Computer imaging with these changes would demonstrate their potential benefit in changing the shape of your face.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: browlift, cheek implants, chin reduction, dr barry eppley, facial shape change, indianapolis, plastic surgery of the chin, rhinoplasty
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Monday, January 31st, 2011
Q: I am 30 yrs old and am tried of people telling me that I am in my mid to late 40s. Ugghhh! I usually just walk away and cry and I am tried of crying over this and want to get something done about it. I have had a brow lift and a neck liposuction about 2 yrs ago. I would like to see what it would look like with eyelid lift and filler. Would you also recommend something else? Maybe a chemical peel? Thank you for your help! I really appreciate it!
A: Thank you for sending your pictures. Unfortunately computer imaging is good at changing structures of the face but not very good at soft tissue manipulations such as those that you have asked for. An eye lift can not be done as it distorts the whole eyelid. However, I think there is no question you have upper eyelid hooding and you would clearly benefit by an upper blepharoplasty or eyelid lift. Putting in fillers along the nasolabial fold and lips is also not very accurate and often just distorts the lips in trying to image it. You have reasonable lip size so injectable fillers will make them nicely bigger. As you have suggested, a chemical peel is good for skin texture and brightening the glow of the skin and for fine wrinkles as well.
As for other recommendations, I have done some other changes just to look at how to soften your facial features and make your face more ‘youthful’. These have included the following:revisional browlift to lower hairline (reduce long forehead) and correct existing brow asymmetry, rhinoplasty to make nose look slimmer and more narrow and chin reduction to soften chin point and make softer looking.These are structural facial changes which are different than just anti-aging procedures.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: browlift, chin reduction, dr barry eppley, indianapolis, plastic surgery of the face, rhinoplasty
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Friday, January 28th, 2011
Q: I had a chin reduction a couple of years ago and although I am happy with the new shape of the bone, I now have hanging soft tissue. Needless to say I am not happy with these results. I have visited five plastic surgeons and none of them wanted to fix this problem saying that it was dangerous to cut or reattach the muscles and the ending results could be worse. I am very dissapointed and have attached some before and after pictures for your review. I hope you can help.
A: Your pictures show quite clearly some soft tissue sag or ptosis off of the chin bone. It is most pronounced centrally which is what one would expect given that your chin reduction was most likely an intraoral burring approach done to the central button. To improve this problem there are two approaches, intraoral muscle resuspension or a submental tuckup. The intraoral approach uses a suture anchor to the bone to reattach the muscle and tighten it back done. This is a scarless approach. The submental tuckup uses an incision under the chin where the loose skin and muscle is removed and tucked or tightened to the bone. Each has its own advantages and disadvantages. The intraoral approach avoids a scar under the chin but the submental tuckup is a more reliable method.
There is no danger to performing this procedure and there is no chance of making the problem worse. Whoever has said has either never treated the problem or is completely unaware that such surgical correction exists.
Dr. Barry Eppley
Indianapolis Indiana
Tags: chin ptosis correction, chin reduction, dr barry eppley, indianapolis, plastic surgery of the chin
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