Q: Dr. Eppley, I believe I have an underdeveloped jaw. In 2008 I had a chin implant which I feel was not correct and seems to sit on my face. Also there is a dip where my chin ends. My jaw is very undefined and seems to blend into my neck. Last year I wanted to get it fixed again. And the surgeon was adamant the chin implant was sufficient but he said I really needed a face lift. I have deep lines from my nose to chin which I hate. Within only a few days after surgery including liposuction to the neck the lines reappeared along with the fat along the neck and jaw. I approached the surgeon and sadly he said what’s the problem you look Younger. Although that was not actually what I was looking for. I have already spent a lot of money and looked and felt no better. I have also had huge issues with my teeth when my wisdom teeth grew impacted causing infections and damage to the other teeth. I am currently having all of these teeth removed at my local dentist. I do have an overbite but was never referred to an orthodontist, my dentist simply removed about 6 teeth when I was a child. I would love to hear your opinion and find out whether you feel there are options available to help balance my face. I am 36 years old and this has really affected my confidence. Many thanks!
A: Thank you for your inquiry. I am sorry to hear that your plastic surgery experiences were not more favorable. In looking at your pictures and your age, the real facial rejuvenative effect would have come from total jawline augmentation not a facelift. Your lower jaw is very short with still significant chin retrusion and high jaw angles. Even with the chin implant in place, whose size is unknown to me, you are still 8 to 10mms short. I think you would be better served by a sliding genioplasty with vertical lengthening jaw angle implants or a total wrap around jawline implant. The key for real facial improvement would be lower jaw augmentation to bring your lower face into better balance and proportion with the rest of your face. You are not a candidate for orthognathic (maxillary or mandibular osteotomies) due to lack of adequate teeth and the need for significant orthodontic preparation even if you had adequate teeth for the procedure. Plus as an adult it is a long orthodontic preparation process before surgery that can create other dental problems. (e.g.,periodontal recession). This you can not really have your lower jaw ‘corrected’ .Therefore you need to do a camouflage approach to the lower jaw deformity by moving the chin bone forward (sliding genioplasty) and augmenting the deficient jaw angles. (jaw angle implants) This keeps your existing teeth where they are and cosmetically makes the lower jaw more advanced and aesthetically balanced.
Dr. Barry Eppley