Should I Have A Sliding Genioplasty To Replace My Chin Implant?
Q: Dr. Eppley, My question is what should type of chin procedure do I need to get the best possible aesthetic result. I had double jaw surgery six weeks ago, and also a medium size silicone implant placed intraorally and fixed with 2 screws. I think most of the swelling is gone now. I’m noticing that my mentalis muscle is acting up again, especially at the bottom of my chin. I thought the implant as well as reduction of my vertical maxillary excess and lower jaw advancement would have resolved the mentalis strain completely. The bumpy appearance is much better than before I had the implant, but I’m unhappy with any dimpling, and am worried that it will return in full force eventually. I also think my chin implant projects too far forward (for a female) and it looks too high. I would ideally like my chin to taper to a slight V in the frontal view rather than the flat U I have now. I also noticed my lower lip looks really asymmetric post-surgery, wondering if it has to do with the implant? What would be the best course of action? Reposition or replace the implant? Fillers? Botox the mentalis? Sliding genioplasty? Thank you for your time and consideration.
A: While an implant offers the simplest approach to chin augmentation, it is usually not ideal in the face of a functional mentalis strain and can produce an aesthetically undesireable widening in a female. From your profile picture, I would agree that it seems too highly positioned which can also place a strain on the mentalis muscle.
For substantative improvement, it now appears that the implant should be replaced by a sliding genioplasty whose dimensional movements I can not say just based in these pictures. That would not only improve the mentalis muscle position but the chin could be narrowed in the frontal view with a v-line reduction technique as well.
Dr. Barry Eppley