Chin Reshaping with Hydroxyapatite Cement

Q: Dr. Eppley, I am interested in chin reshaping. I was wondering if it is possible to turn a slightly tapered chin into a more curved, U-shaped rounded chin without the use of implants? Are there bone cements of some sort which are able to achieve this?

A: Chin reshaping that involves augmentation can be done using a variety of materials and implants. The problem with the use of bone cements for this aesthetic purpose is their cost, workability and smoothness. It is very hard to get bone cements placed through a semi-wet intraoral approach in a tight subperiosteal tunnel that will allow them to set up and be shaped properly. It is not impossible but their use is much more potentially problematic than that of preformed implants. Hydroxyapatite cements are mixed into a putty intraoperatively and then applied and shaped. Until they are fully set they are easily deformable. While partial set is achieved in 10 to 15 minutes, a full set may take a day. Based on these working properties it is easy to see how they can be potentially problematic for stable and assured facial bone augmentation. The use of hydroxyapatite granules is not any better as granules do not acquire a stable set shape during surgery. 

Dr. Barry Eppley

Indianapolis, Indiana