Should I Have A Chin Implant Replacement?

Q: Dr. Eppley, Hello. I had a large chin implant placed 4 weeks ago. I believe it is too large/high. I also can not smile. Would you recommend replacing the implant? I included some before pics for reference. The collage are all before pics, just some are from when I was younger. Thank you for your time. I wish I had found you 4 weeks ago! 

A: Thank you for your chin implant replacement inquiry and sending your pictures. While your chin was naturally short/smaller, it is a ‘compressed’ type of short chin which means there is a vertical component to the chin deficiency as well. (as evidenced both by vertical facial third assessment and the deeper labiomental fold) Your chin implant may or may be too high but when just horizontal advancement is done in a chin like yours, the vertical shortness becomes magnified…and you have all of the symptoms that you describe. While chin augmentations do take a full three months to see the true result, I would agree that the symptoms you have now both aesthetically and functionally are not going to substantially improve. You really needed a 45 degree type of chin augmentation in which the vertical lengthening with less horizontal projection is the more appropriate dimensional change. Your current implant relies exclusively in the horizontal projection to achieve its effects…which in many patients is fine but it just doesn’t work well with your chin anatomy.

Your options now are:

1) Remove and replace your chin with a small vertical lengthening style which produces a 45 degree type of projection. (5mms forward and 5mms down)

2) Remove the chin implant and replacement with an opening sliding genioplasty with the same type of dimensional movements as #1 option.

Dr. Barry Eppley

Indianapolis, Indiana