How Soon After Custom Jawline Implant Surgery Can I Work Out?
Q: Dr. Eppley, Hello and how are you? I am emailing you as suggested by Camille with my inquires and photos. First let me begin with the background. Overall, I am happy with my face and think I am approaching this from a decent baseline but I was wondering if it is possible to enhance it with a change that can still be subtle. I am seeking the chiseled jaw look. Although I am a male, I was inspired Angelina Jolie’s chin projection jawline very much (although she may had other work done along with a low percent body fat). I am wondering if chin and jaw implants (specifically the jaw implant that emphasizes a stronger angle as opposed to increased width) or wrap around implant would give me my desired look. My concerns is having a swollen face look even after the healing has completed or having a drastic change. One thing to note myself is that I had fillers placed, my last round was over a year ago in the chin and jaw lines, hopefully this won’t be an impediment to your assessment. Below is a list of questions along with a video. Also note, there is a picture from the RealSelf website of a prior patient. I put it up there because it is one of those cases where the before or after is too drastic!-hence my desire for subtlety. Any feedback is greatly appreciated!
1 I am scared about nerve damage, can you comment on that, particularly your success rate and experience with this? -especially if the implant is a wrap around.
2 I am also scared about the swelling and realizing it will take months for it to get back to normal only to see that my new face is a swollen look. How common is that concern, how do you counsel?
3 Is it possible for changes I desire to be achieved yet subtle so it’s not obvious to others or does that defeat the point?
4 Is it possible for computer imaging to show what I will look like after the implants?
5 I am also physically active, I assume I won’t be able to lift weight six to eight weeks after? or would it be longer?
6 How often are people not satisfied with their result and thus request a removal? Does their face go back to normal?
7 Roughly how much could this cost (i.e what is the most expensive this could be?)
8 I live in NYC, thus this impact your practice given COVID, also how long would I have to stay and how soon could I go back home?
9 I also suffer from psoriasis and on an immunomodulator suppressive therapy, thus does that play into any factor? Do people immunologically react to the implants? Can all the incisions may be intraorally only?
10 Do people feel the implant ?
11 Does having some filler in the face complicate the surgery?
12 Also you will see in the video that my face gives ME the impression that I have a fatty chin when I have been told that is not true, would implants incidentally ease the appearance?
Thank you Dr. Eppley,
A: In answer to your custom jawline implant augmentationquestions:
1) The only nerve of any relevance is the mental nerve which controls feeling of the lower lip. This implant is passed under that nerve which can cause some short term temporary numbness in a few small cases but not permanent loss of feeling.
2) While the swelling can be considerable from a patient’s perspective most of the significant swelling is but a few weeks (2 to 3 weeks) where one may feel a bit distorted. I can say that I ever recall a patient months down the road that ever look ‘bloated or just had a fat face as implants expand the tissue. But it is true that thinner faces always end up with more defined results with smaller sized implants.
3) Your question is based on the common misconception that other people are a lot more observant than they really are. Just because you know you had a jawline implant doesn’t mean other people can even tell almost regardless of the magnitude of change for two very specific reasons…1) people can only recognize plastic surgery procedures that they know exist (99.9% of the world would never believe a total jawline augmentation change is even possible) and 2) everyone is a lot more concerned about themselves than about you. They are a lot more worried about themselves not looking right or looking good most of the day than they are perceiving any change you may have done.
4) It is a requirement than every facial reshaping patient undergoes computer imaging. But your perception of the role of computer imaging in facial surgery, which is common, is inaccurate. Computer imaging is about setting the target…what is the patient’s goal? As the old motto goes one can not hit a target they do not have. I have no preconceived notion of what type of change you want and frankly I don’t care what your jawline augmentation goal is. I only care about what you want so I can strive to achieve it. That is the real purpose of computer imaging. We may or may not hit the target exactly but we have a much better chance if I know what it is. Such a philosophy takes on the greatest relevance in custom facial implant surgery where the creation of specific implant dimensions are required.
5) Your assumption in regards to working out/weight lifting is inaccurate. You can do any of these activities when you feel comfortable to do so. Such activities will not displace the implant nor interfere with its healing.
6) Almost no one ever requests a removal. They may want it revised bit almost never just removed.
8) Other than requiring patients to have a negative COVID test before surgery, there are other unusual preoperative requirements. The goal is to get the patient home asap, usually within a few days. There is no advantage or need to remain here. You want to get home to recover on familiar ground.
9) The would depend on what type of immunosuppression you are on. But I can assume since the treatment is for psoriasis that it is a more contemporary drug regimen as opposed to prednisone etc. Implants do not evoke an immunologic reaction and no one develops an immune reaction to the implant materials. Implants can get infected which is often confused with being ‘rejected’ or developing an ‘immune reaction’. I rarely place jawline implants through an exclusive intraoral approach since that has a higher rate of infections. While the back incisions are placed inside the mouth, the front incision is placed under the chin.
10) No more than you can feel your own jawbone now.
11) The location of synthetic fillers is irrelevant in regards to both designing an implant or surgically placing it.
12) I would defer to computer imaging to visually answer the question as to what will happen to your ‘fatty chin’.
Dr. Barry Eppley