Q: Dr. Eppley, I would like a more elongated lower 3rd of my face with less of a square look. I previously had liposuction done underneath my chin but it has never improved. Will the chin augmentation improve this area? Also, approximately how much length in mm is needed to achieve what I am looking for? Thank you!
A: You have a very distinct chin augmentation need. Your square jawline and distance between the base of the nose and the chin indicates that there is a vertical lower facial deficiency. I would not have expected liposuction under the chin to change what is a skeletal issue. There are twi fundamental approaches to managing a vertical lower third of the face deficiency. If it is just located anteriorly a vertical lengthening sliding genioplasty or a custom vertical lengthening chin implant can be used. If one feels the entire jawline is vertically short from front to back only a custom jawline implant that lengthens the entire jawline can be done. In looking at your face my feeling is that a vertical lengthening sliding genioplasty would probably be the best choice. In my experience at least a 7mm vertical increase is usually needed to make a noticeable vertical chin augmentation change. This is done by an open wedge bony genioplasty where the front edge if the bone rotate down while the back edge of the bony cut keeps the bone in the same position. The exact measurement of vertical chin lengthening needed can also be determined by two other methods. One can open their lower jaw to the vertical chin length that looks good to you and measure the created distance between the front teeth. One can also take measurements of their facial thirds and then see how short in millimeters the lower facial third is. I would do both methods to see how well they correlate so you can select the most effective vertical chin augmentation improvement.
Dr. Barry Eppley