Do I Need A Custom Chin Implant?

Q: Dr. Eppley, I am considering more about the chin implant and appreciate the computer imaging that you have done. My question is do I really need to enlarge my chin so much? Actually as far as I know the largest chin implant by Medpor enlarges chin by 7mm. Actually it looks better from the side view, but I am also was worried about asymmetry of the face from the front view. So I thought  to put the Geniomandibular Groove implant to right side only to correct it. But while would it correct the asymmetry, I would not look better from the side view. By using the Medpor RZ chin implant, is it possible to trim in operation or I would need to order jaw model by CT for custom implant because of the asymmetry?(  ) How long would it take to get and much would it cost? Do you think I need a custom chin implant?

A: The imaging shown is just a point to begin the discussion of the changes you would like. Certainly the amount of horizontal chin projection can be less. But I would not go less than 7mms because anything less than that would not make much of a noticeable change.

Geniomandibular groove implants will not provide much horizontal projection, maybe 1 to 2mms. They are used primarily for vertical lengthening of 3 to 5mms and to fill out a notch at the lower mandibular border.

Your best off-the-shelf chin implant option would be the Medpor RZ extended square implant of 7mm projection. The wings of the implant could be intraoperatively modified  to try and compensate for your facial asymmetry along the jawline. I would expect improvement in the asymmetry but not ideal correction as this is a stock implant not a custom one…and your problem is obviously unique to your anatomy and not a ‘stock’ problem.

While custom implants are ideal for any patient, it is always a question of whether the cost is necessary for the amount of aesthetic improvement. That will always depend on the patient’s problem and how asymmetrical or unique the bone problem is. At $3500 extra costs to get it made, one does have to give that good thought. I think it depends on what one is prepared to live with when it comes to the result. In your case, if you can live with improvement but not ideal symmetry than I would go with  an off-the-shelf implant.

Dr. Barry Eppley

Indianapolis, Indiana