How Can I Augment A Chin That Has Had A Prior Mini V Line Surgery?

Q: Dr. Eppley, I had a genioplasty in S. Korea to shorten my chin and reduce my lower facial thirds two months ago, since it was too long in my opinion. While the Dr was able to successfully reduce my chin vertically to a length that I desire, I am not happy with my 45 degree profile and side profile, since my chin was shaved inwards, and now looks recessed and gives me the appearance of a double chin. I have contemplated fillers vs an implant vs sliding genio. I concluded that I cannot get a sliding genio since my chin now doesn’t have enough bone, and I also do not want fillers since their is risk of migration and touch-ups which can be expensive. I am thinking of getting an implant, but that however also runs the risk bone re-asorbtion, the implant moving, etc. I actually already have titanium implants in my jawline six months ago as well and they have adapted to jaw angles quite well, so is that a sign that bone re-asorbtion is less of a risk for me? Am I an ideal candidate for a chin implant, and if so at what stage can I get it post-op; is it better to get it asap or later on? What material is best recommended for me? Attached are my CT scans pre-op and post-op from this procedure.

A.:How to augment a chin that is has had a prior mini V line surgery can be done in one of two ways. First you do have enough bone to do a secondary genioplasty to move it forward. This would be the correct procedure if the patient is opposed to an implant or has any implant– related concerns. It may be the more invasive procedure to do but your 3-D CT scan shows that it can be successfully done. The less invasive non-bone cutting procedure of course would be an implant of which I have no concerns about implant migration or any significant implant settling (the term bone erosion is a biologically flawed) this approach offers not only not repeating the bone cut but with a custom implant design control of every implant dimension.

I think the secondary chin augmentation choice comes down to your emotional preference as well as how much augmentation do you really need in terms of millimeters of advancement. Most likely and having done many female cases like yours it probably is a function in the 2 to 4 mm range at most.

Dr. Barry Eppley

World-Renowned Plastic Surgeon