How Can I Avoid Overcorrection In reversing My V Line Surgery With A Custom Jaw Implant?

Q: Dr. Eppley, I am unfortunately experience massive post-surgery regret after undergoing vV line surgery in South Korea. While the surgery was performed well, I do not like the aesthetic result. I am now considering implants to restore the jawline. I fortunately have my pre-op CT scans available, and will be looking to have my jaw implants 3D modeled off those pre-op CT scans. However, my concern is overcorrection. I understand that surgical placement can deviate +- 1mm, so would like to avoid looking “wider” than my pre op state.Would this achieve the balance of restoring my previous jaw shape without risking overcorrection? Or is it too conservative? Would following the natural curve/geometry of my pre-op jawline, but at a reduced scale of say about 80%, achieve noticeable/satisfactory results? I also underwent a genioplasty where my chin was set back 3mm. I am not sure if it is due to the jawline shaving, but my chin somehow looks more protruded/bigger despite the setback? Would restoring my jawline without changing the chin make the chin more proportioned? Or would it be advised to restore the chin as well? I have attached CT screenshots.

A: I have seen many the line surgery regret patients from surgery in  South Korea who all have a similar story. The surgery is almost always technically performed well but it just turns out to be the wrong operation for the patient’s objectives.  And the reason that happens is three fold: 1)  the patients objectives through preoperative imaging were never established, 2) the operation is done largely in a cookie-cutter fashion meaning everybody gets the same operation done the same way regardless of their native facial structure or what their aesthetic objectives and 3) by definition Eastern style V line surgery creates a radical change with vertical amputation of much of the jawbone. As a result some patients are going to feel over reduced just as you have.

The only definitive reversal procedure is a custom jawline implant to replace some or all of the missing bone. I would agree that the principal objective is to avoid over correction. There is a reason you had the initial operation and most patients are only looking for partial restoration as there is a reason one had the original surgery. This is indicated by your own theoretical numbers as you think about the dimensions of the jawline and implant replacement.

Lastly I am certain your chin still looks too big because the jawline behind it is not proportionate.  The chin setback procedure only treated part of the over reduced problem.

Dr. Barry Eppley

Plastic Surgeon