Chin Implant Overlay on a Prior Sliding Genioplasty

Q: Dr. Eppley, I found your profile on RealSelf and it appears you seem to be quite experienced and knowledgeable about facial implants.

I’m of Asian descent and one year ago I had my chin narrowed and moved forward in Korea. I’m near happy with the results of the surgery but I desire more horizontal movement. I regret asking my original surgeon to stay conservative but I guess I would prefer less than too much. 

I’m thinking of going abroad again to get a small chin implant, as I think recutting the bone for such a small additional movement is overkill. Surgery in my home country is also unbelievably expensive and not exactly very well versed when it comes to asian aesthetics.

The only thing is that I am deathly afraid of getting an infection. I’ve read on RealSelf that most infections tend to show themselves in the first week up to three weeks post operation. What’s the likelyhood of infection appearing after this period? 

More so, I worry about the implications of cutting through the mentalis muscle twice. As I am Asian, I have been rejected for extraoral incisions due to the scarring implications. Does cutting through the mentalis muscle again have consequential possibilities such as a drooping lip or chin sagging? 

Thank you for your insight.

A: The way to lower the risk of infection to the lowest possible is to use a submental skin approach. That also avoids cutting through the mentalis muscle and quickens recovery. That is a 1 cm incision which I have not seen that to be a ‘scarring’ issue. I have done many Asian male patients through that approach.

But since that approach is off the table, the risks of infection with intraoral placement are higher, how much higher no one can really say. Such infections do not occur in the first week or so but 3 to 6 weeks after surgery. That is typical take period for all facial implant infections.

I don’t consider cutting through the mentalis muscle twice of major concern.

Dr. Barry Eppley

Indianapolis, Indiana