Do I Need A Custom Chin Implant?

Q: Dr. Eppley, I did a chin implant recently and I chose EAC L, which doesn’t seem sufficient – things look smaller and thinner still and not tall enough. Flowers Glove offers 1.75 cm of height and significant mass, but people’s chin looks like a potato or golf ball and is not as athletic afterwards. I think my next move is a custom implant. To do this right, I need imaging (not 3D, on my real picture), to see what the custom implant will roughly do. My current surgeon does not offer such imaging – do you? Attached pics are from now, which is 2 months after surgery.

A:Thank you for your inquiry and sending your pictures. The fundamental dimensional problem of your current chin implant result is that it lacks vertical height. Vertical height refers to an extension of the inferior border of the bone. No standard implant really does that satisfactorily. You simply have had a chin implant which has been placed with no real consideration of the need for vertical lengthening in which you have always had a vertically short chin.

When it comes to imaging it is important to understand that its purpose is to determine the patients goals not to show a result that will actually happen as no one knows that for certain. Imaging determines the target which serves as the type of surgery that the surgeon thinks is most likely to come closest to achieving. In that regard I have attached an image in which I am demonstrating some increased vertical height to the chin augmentation results you already have which appears to be adequate from the standpoint of horizontal projection.

Ultimately you will need a 3-D CT scan so we can understand what your current implant is actually doing based upon the way it is positioned on the bone. Whether such an imaged change can be achieved by a custom implant or whether it may require a vertical lengthening bony genioplasty remains to be determined of which the 3-D scan will provide invaluable information on that decision.

Dr. Barry Eppley

World-Renowned Plastic Surgeon