Custom Jawline Implant and Neck Contouring

Q: Dr. Eppley, I’ve been carefully considering everything and I think I am going to put off getting calf augmentation and custom infraorbital-malar implants until future procedures, if I choose to do so. I am still interested in the following:

-Custom Jawline

-Buccal Lipectomies with Perioral Mound Liposuction: Bilateral

-Septorhinoplasty

-Fat Grafting to: Labiomental Fold

I have some questions about those procedures and some others I’d like to consider:

1) If I got a custom jawline implant, would it be attached to my jaw bone with screws? If yes, would this affect my ability to have an MRI in the future if I needed one for any reason?

2) Can a custom jawline implant make snoring worse?

3) We talked in my consultation about submentoplasty, you considered it a bad return on investment because it was likely I would get the jawline definition I was looking for from an implant only. I am a little confused about the description of the procedure. Is it just fat removal/liposuction? Do you also tighten the platysma muscles? What I am trying to achieve with submentoplasty is to get a much sharper angle between my neck and my jawline as seen in the before/after picture I have attached. 

4) If I’d like to treat the my under eye hollows/bag with fillers instead of implants, what kind of fillers would you recommend? How long do they last, do they deteriorate slowly over time or all of the sudden? How many syringes of filler would I need?

5) I feel like I have some breathing difficulties and I know for certain that I snore loudly and would prefer not to. Do you offer somnoplasty/turbinate reduction? I’d like to get my soft palate/uvula and turbinates targeted to treat nasal obstruction and habitual snoring. If you do offer it, do you perform it often? Is this a procedure that I need some sort of medical evidence/sleep test results to show that I need it?

A: In answer to your questions:

1) All jawline implants are attached within screws. There are titanium so they are non-magnetic.

2) No.

3) A submentoplasty is a combination of liposuction, fat removal beneath the platysma and muscle tightening.

4) The only fillers that should be placed in the thin undereye tissues are hyaluronic acid-based of low viscosity. Most people need at least 0.5ccs per side or at least 1 syringe,may be 2.

5) I perform inferior turbinate reduction regularly and are part of most septorhinoplasties when there is breathing impairment present.

Dr. Barry Eppley

Indianapolis, Indiana