How Can I Elongate My Face and Full In The Prejowl Sulcus?

Q: Dr. Eppley, My goal is to elongate my face vertically and fill in pre jowl sulcus with in a chin implant. I could use a slight horizontal projection because my chin projection is decent but it would help my chin shape. Most of all the implant wings will help fill some indentation on the sides of my chin between my chin and jowls (pre jowl sulcus area).

I thought the Implantech “vertical lengthening chin implant” would be great to elongate my face but another surgeon thought the wings may not help with jowls and may cause a little worse indentation. He said no implant is perfect and asked what is more important (elongate of fill the pre jowl sulcus). He thought the Implantech extended anatomical chin would work. I don’t think he has much experience. I have only see 4 pics of the before and afters. He has never done a custom implant either. A custom implant may meet both needs. My face is very square and my chin is not much lower than my jaw. Now my skin is sagging and starting my jowls are drooping and making it worse.

A: Thank you for your inquiry and sending your pictures to which I can say:

1) By your own detailing of aesthetic chin needs you are describing a custom chin implant design. No standard chin implant can achieve all of those reshaping objectives.

2) It is common that surgeons look at what they know how to do or are most familiar and then try to apply it to every patient need they see.  The effectiveness of that approach drops dramatically when the patient’s needs are not a good fit for what the surgeon knows how to do. (the old trying to fit a round peg into a square hole)

3) Be aware that you do have some soft tissue jowling for which an extended vertical chin implant design will not completely resolve.

4) The first step is to determine what your exact desired chin dimensional needs are. In that regard I have attached some initial imaging to begin that discussion.

Dr. Barry Eppley

World-Renowned Plastic Surgeon