Can I Restore My Chin After Chin Reduction Surgery To Look Like My Old Chin Before The Surgery?

Q: Dr. Eppley, wrote a month ago with regret after a chin reduction procedure, and if you don’t mind, would you answer some further questions? I had a CBCT scan done before my reduction. It was done intraorally, and the surgeon removed 4.9mm bone from the bottom of my chin then smoothed and rounded the shape. He did not cut into the bone to remove a wedge. I am still regretful, I miss the old length and squarer shape to the chin, despite this being more masculine looking (I am a female) I do think it suited my face and figure better and I miss how I used to look.

The surgeon has suggested another CT and comparing the difference between this and the pre surgery CT and having a custom made chin implant from PEEK material.

My questions are as follows:

1. In your experience with similar cases, with this method how likely is it that my chin will look like the old one?

2. The tubercles of the chin were removed with the reduction, will the custom implant shape give the appearance of these back?

3. The surgeon spoke of placing the implant via the intraoral route, he did not give a reason and I will need to ask his reasoning at our next appointment, but do you see any reason this can’t be done submentally and with local anaesthesia only?

4. The implant will be fixed in place with titanium screws, is this painful, and a reason for using sedation or general anaesthesia?

5. For patients you have seen with facial contouring regret and subsequent restoration with implants, are they generally happy with the results of the implants and do they report that they feel like/recognise themselves again?

6. In this situation, how long should I wait from the initial surgery to having a custom implant made and placed or does it not matter? Is there a possibility my chin bone changes/bone regrows at all?! I’m concerned then that putting an implant on top will make the chin bigger and different to the original. I am looking to have as close to my original chin as possible.

Thank you for reading Dr Eppley, and best wishes to you.

A: In answer to your chin reduction questions:

  1. It is fair to stay that with a pre and post reduction 3D CT scan you would come as close as humanly possible to restoring your original chin shape.
  2. A custom design would replicate the original chin shape with the lateral tubercles since you have a pre reduction scan.
  3. The custom chin implant could be placed submentally. The choice of anesthesia is between the patient and the surgeon, both have to feel comfortable that the implant can be successfully placed regardless of the anesthetic choice. I could answer that question more decisively in regards to local anesthesia once I saw the size of the implant.
  4. While screw fixation is essential it is not painful.
  5. Most facial bone restoration patients move on after they have ‘returned back home’ or as close as they can get to it.
  6. Given that the custom implant design process is several months in duration you initiate it as soon as you are convinced it is needed.

Dr. Barry Eppley

World-Renowned Plastic Surgeon