Q: Dr. Eppley, I tried to get pics of my face to show my lower third facial deficiency. I live alone so had to use a selfie stick and tried to get different angles. Not too happy with my nose either but maybe it won’t look so prominent if I had a more defined jaw line.
A: Thank you for sending your pictures. You did a good job with the selfie stick. You are correct in that your very short chin/jawline magnifies the size of your nose. When it comes to chin augmentation, all available options are on the table so to speak, each with a slightly different result. The best one in my opinion, due to the degree of short chin/jaw that you have is a sliding genioplasty with a chin implant overlay. Moving the chin bone out (not the whole lower jaw just the end of the chin bone) helps the neck a lot because it pulls out the attached muscles with it as the chin comes forward. It also serves as a bony foundation for the most of the chin augmentation and lowers the risks of just a large chin implant placed alone. The purpose of the chin implant overlay (small chin implant with long wings) is to primarily add some width to the chin at the back end of the bone cuts, which addresses the aesthetic problem of sliding genioplasties in some patients from making the chin appear more narrow from the front view as it comes forward. In essence in challenging cases of congenitally short chins, this approach combines the best features of a sliding genioplasty and a chin implant…each of which has their own aesthetic limitations in the very short chin patient.
Attached is some imaging of you as well as an example of what the technique which I have described.
Dr. Barry Eppley