Can A Custom Wrap Around Jaw Implant Elongate The Lower Third Of The Face Like A Chin Wing Osteotomy?

Q: Dr. Eppley, It indeed is possible to remove the existing silicone chin implant, perform sliding genioplasty (should there be a need to that, of course) AND insert a wraparound jaw implant (that would cover the chin too) in the same surgical procedure…(?). if so, wouldn´t that place too much strain on the chin, as it would take the biggest brunt of the surgery (implant removal, genioplasty + new implant)?

  1. If I gather correctly, wraparound implant can elongate the lower third of the face in the manner ChinWing can…(?). 
  2. As for the fat along my jawline, it´s been almost a decade it has been injected, but it is still very much present and does mimic a facial implant to a degree (ca. 7ml of fat on each side) which is of concern to me for it may interfere with how the final result would look like. Hence my question: could that fat be take out – at least partially – either in a separate session under local anesthesia a few days before the main surgery, or under the same surgery…?
  3. Finally: silicone or peek custom implants? Which are preferable in terms of patient safety, avoidance of (delayed) infection, aesthetics and easiness of placement on the jawbone…?

A: In answer to your questions:

1) Removing a chin implant, replacing it with a sliding genioplasty and simultaneously placing a wrap around jawline implant does not place excessive strain on the chin. I have done it many times.

2) A custom jawline implant elongates the lower jawline more effectively than a chin wing osteotomy.

3) Once fat is injected in the face it is very difficult to remove. Attempts to do so would require a microcannula liposuction approach done months before the definitive jaw augmentation procedure.

4) A solid silicone jaw implant offers the easiest insertion/placement and eae of revision or reversibility.

Dr. Barry Eppley

World Renowned Plastic Surgeon