Can Hydroxyapatite Be Removed From The Chin And Replaced?

Q: Dr. Eppley, I had an hydroxyapatite chin augmentation several years ago. The hydroxyapatite was semi-solid or loose when implanted- mixed I believe with some fluids, but it was not cut from a block. It was implanted intraorally. Besides not doing much from my chin, it appears that the chin tissues are more loose now and hanging somewhat. I would like to see if we could perhaps fix this problem as much as possible. The tissue also appears more red in color that the rest of my face after surgery. I have attached some pictures of my face for you. I did take them myself from short distance so they do appear a tiny bit distorted, but they give you a good look at the chin and jaw angles in particular. In terms of enhancement to my jaw, I am not necessarily looking for a massively dramatic distal increase in size- just a moderate one to give a sharper look to the lower part of my face and to help with structure as I age. 

A: Thank you for sending your pictures. I can’t say that I see any significant soft tissue detachment of looseness per se but the chin is horizontally short.  It may feel somewhat looser as the hydroxyapatite granules are not structurally supportive. The hydroxapatite paste put in the chin usually have very little push to it so its augmentative effect is very minimal and often can be very irregular. I am not sure why the chin button area is slightly red as hydroxyapatite is usually very biocompatible. Certainly the hydroxyapatite granules can be removed and other forms of chin augmentation done. A more stouter form of chin augmentation will do a better job of picking up the loose chin tissues as well as providing more of an augmentative effect. At the same time, jaw angle augmentation focusing primarily on vertical length can be done as part of an overall jaw enhancement strategy.

Dr. Barry Eppley

Indianapolis, Indiana