Does A Lower Jaw Thrust Accurately Represent The Vertical Chin Lengthening I Need?
Q: Dr. Eppley, Hello. Here you can see that by extending my chin down and outward, it corrects 3 key flaws:
1) Lack of lateral chin projection. Before: from side view, the foremost point of the chin is slightly recessed from the foremost point of my lips. After: the foremost point of the chin now extends just *past* the foremost point of my lips.
2) Lack of vertical chin height. Before: from both side and front views, the jawline is weak and undefined, and the lack of height leaves the lower third of my face unbalanced with the rest. After: the jawline is accentuated and the lower third of my face is well-balanced and much more masculine.
3) Deep labiomental fold. Before: from both side and front views, the labiomental fold is excessively deep and concave, giving my lips an overly pouty look. After: the labiomental fold is much straighter vertically and more smooth, thanks to the added vertical chin height and lateral projection.
I understand that moving my entire jaw to simulate the desired look of the chin doesn’t give the most precise representation of a chin surgery result, but it does show that adding vertical height and lateral projection to the chin can significantly enhance the masculinity of the lower third of my face. I’d like to know if you disagree with any of this, and approximately what dimensions in millimeters of added height and projection you think would best achieve the optimum result. Thanks!
A: Thank you for your inquiry and sending your pictures. The jaw thrust is a very good method to determine that vertical chin lengthening is beneficial. What it also illustrates is that the chin movement must be at least a 45 degree type of augmentation, meaning that an equal amount of vertical and horizontal augmentation is needed. I would estimate that the change you are demonstrating is probably in the range of 7mms horizontal and 7mms vertical, maybe 8 and 8.
Now that these dimensions are known the critical question becomes how best to achieve them. It is important to know that the soft tissue chin pad has limits in which it can be stretched unlike the rest of the jawline. That limit at best is a combined number of 12 to 15mms. (adding the vertical and horizontal augmentation needed) Thus this change can probably not to be done by an implant alone as the soft tissue chin pad will probably not stretch over it. This will requiter a combination of a opening wedge sliding genioplasty (to get all of the vertical length and some of the horizontal) and a chin implant overlay.(to get the rest of the horizontal and to make sure the chin width stays wide as the bone comes down and forward.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.