How Soon Can I Get A Chin Implant Revision?

Q: Dr. Eppley, I am writing to you because I am very sad as I had surgery on my chin but the result was not what I expected and now it is very hard. Due to a retruded chin and chin asymmetry, I entrusted myself to a maxillofacial surgeon and decided to insert a customized peek implant.

The implant (as you can see from the attachments) was designed with 14mm forward projection and only 1mm in height, although the height of the implant is almost insignificant my chin now appears much higher than before, perhaps it was my chin bone which was already very high before but being retuso it was not noticeable in height, now with the same height but with more forward projection an exaggeratedly long and heavy chin appears for my face.

Only 10 days have passed since the operation but the height is really too much to think that it will change a lot in the next few days, I have some questions:

1) The problem is due, as I suspect, to the length of my chin which is retracted but also very long, so bringing it forward with a prosthesis will it seem taller than before?

2) In case the problem is the length of my chin bone if I made a customized prosthesis that as it comes forward it rises and shortens in height would it be a feasible solution to make the chin less high or in this way my chin would look strange?

3) What would be the best solution to overhaul the chin so that it is shorter in height?

4) Being already sure that I will have to do a revision of the chin, how long is it best to wait before doing a new operation on the chin?

It’s hard to trust other surgeons now I only trust you, for this I really appreciate your opinion

A: In answer to your chin implant revision questions:

1) The first thing to realize is that you are early in the recovery process and have a lot of swelling. You are not even 50% of the way into the recovery process. So I would expect at just 10 days after surgery to have a lot of swelling and tissue distortions…which are not representative of what the outcome may be. You also have to realize that this is a very large chin implant, way beyond what most patients get, so the swelling and tissue firmness/distortions will be extreme. I never judge the outcome of any chin surgery until at least 6 weeks after surgery. This is the minimum time to make even a preliminary judgement.

2) It is likely the soft tissue chin pad is riding high, besides the swelling, is because a 14mm implant creates a large implant mound to try and get the soft tissue chin pad to be able to be pulled over it during closure. Quite frankly I would never try toput in a chin implant over 10mms unless the patient had an indwelling chin implant to help stretch out the soft tissue chin pad first. Given your initial significant chin deficiency I don’t think a chin implant of this size was a wise choice. When you want this much horizontal chin movement this is the role of the sliding genioplasty where these soft tissue chin problems do not occur.

Dr. Barry Eppley

World-Renowned Plastic Surgeon