Q: Dr. Eppley, Hi, I’m interested in improving vertical chin lengthening. Below are attached pictures of before and after application of 1 and then 2 syringes of Juvederm Volume below my chin to increase vertical projection. I like the result but considering a more permanent option. In my research it seems that most chin implants address mostly horizontal projection. My horizontal projection is fine but I would like to increase vertical projection to get more sharper look in profile. I’m in great shape and don’t think dieting and more exercise would greatly improve my facial profile or remove the appearance of double chin. Would like to get your opinion on options. Thanks.
A: When looking for vertical chin lengthening, there are two options. An opening wedge siding genioplasty would be the autologous option. The chin bone is cut and open vertically downward and then plated in its new vertical fashion. The other option is to make a custom chin implant that mainly adds a vertical dimension increase. The decision between the two would be based on how much vertical increase one seeks. Large amounts of vertical increase are best done with a vertical bony genioplasty since it carries the soft tissue downward with it as it remains attached to the bone. With a custom chin implant it is important that enough chin soft tissue is available to be mobilized over the implant.
Lastly, vertical chin lengthening is not going to be enough to completely eliminate the double chin. Liposuction of the submental region would need to be done as part of the chin procedure.
Dr. Barry Eppley