How Can I Get A More Square Cut Lower Face?

Q: Dr. Eppley, I want to achieve a more masculine jaw line. My face is oval and I want a more square cut lower face. I had a chin implant back in 1990 with a rhinoplasty. Would like to know what my options are and also would this implants just be inserted or are they secured with screws. How many days do I have to stay inIndianapolis before flying back to home. Thanks so much for your fast response.

A: Thank you for sending your pictures. I did some preliminary imaging based on what I perceive as your desire for a more masculine jawline. This was done using a combination of chin and jaw angle implants, the most common approach to make a circumferential change to the jawline. One interesting issue with you is that you already have a chin implant and the change to get you to the imaging result is significant. This raises the question of whether an off-the-shelf (stock) chin implant can really achieve that goal of which I have doubt. This leaves the possibility of either making a custom chin implant or doing a combined sliding genioplasty with a small square chin implant placed in front of it for the square width effect.
All facial implants are always secured by screws for stability of position on the desired bone position long-term.
No matter how it is done, you would be returning home 48 hours after surgery.

Dr. Barry Eppley