Should I Get My Misplaced Vertical Lengthening Chin Implant Repositioned?

Q: Dr. Eppley, Thank you for confirming the suspicion. I see now that it was positioned as a standard chin implant rather than how a VLC implant is designed to be placed. Since the implant is positioned incorrectly, how much vertical height (if any) do you think it is giving me currently? The edit looks much better than what I have now. I am most interested in improving my frontal view the most; I was wondering if you could send an edit of the frontal view photo (if it is not too much trouble). I want a look that is similar to the lower thirds of the reference photos that you and I reviewed. One of my main fears is that I won’t be able to achieve the vertical length of those photos without an 8mm+ movement. Ideally, I’d prefer an implant over genioplasty because of the invasiveness, but I’d like your opinion on the most appropriate procedure knowing what we know now.

I have a few questions: 

1) How much vertical movement do you think that I would need to achievethe height in the goal photos? 

2) What is the maximum vertical and horizontal projections of a custom vertical lengthening chin implant?  

3) How much more vertical length can I get from a custom chin implant in comparison to the VLC standard that I have in?

4) Taking my goal photo references into account, which procedure(s)would you recommend most to achieve my goals? My options are: modifying the existing VLC implant, vertical lengthening genioplasty w/ standard chin implant overlay, and a custom chin implant with an extended wing design.

A: In answer to your vertical chin lengthening questions:

1) Probably 5 to 7mms vertical

2) The tissue tolerances of the soft tissue chin pad for any implant augmentation is the number 12mms. (any amount of horizontal and vertical changes when added together)

3) It doesn’t matter whether it is custom or a standard chin implant you can not usually exceed the 12mm number)

4) Based on the information I know I would choose the custom extended chin implant. Then you control all variables including how it blends into the jawline behind the chin.

Dr. Barry Eppley

World-Renowned Plastic Surgeon