Should My Chin Implant Be Replaced By A Sliding Genioplasty?
Q: Dr. Eppley, I am a 26 years old female. I had a chin implant surgery along with a rhinoplasty three years ago. I was happy with the surgery results until I started to see how I looked in pictures. I think that my face looks too long, and in some pictures it looks really especially when I smile. I also dislike my gummy smile, though I can hide it when I try not to rise my lips. I don’t know what the problem is. What would be the most recommended procedure for me? I would like to look more feminine and balanced. Could a smaller chin implant make my face more balanced? are there any risks involved?
Could cheek fillers or implants help? Or should I also consider the possibility of orthognathic surgery, in case the camouflage would yield very limited results..
What other procedure would you recommend for me? The upper part is me before the surgery, and the lower part is me after the surgery. And I also attached my X ray.
A: While both your rhinoplasty and chin implant augmentation produced good results, I see the crux of your facial concerns with the chin area. It is a very large implant which was needed but is also the source of your facial imbalance.
You initially have a very retrusive chin due to an underdeveloped lower jaw. When the chin is so short due to an underdeveloped ramus of the back part of the lower jaw, it is also vertically long anteriorly as the chin rotates downward. With a chin implant used for the augmentation, it does bring it forward but also actually makes the chin vertically longer and with a much deeper labiomental fold. A better chin augmentation would have been a sliding genioplasty. This would also bring the chin forward but it vertically shortens the chin and makes it more narrow, both changes which are more feminine.
Thus I would recommend that you replace your large chin implant with a sliding genioplasty that does not create as much horizontal projection but also vertically shortens it as well. It will also make the chin more of a triangular shape rather than have an obvious square shape to it that it has now from the outline of the implant. You may also consider adding small cheek implants to bring a little highlight to the cheek area, which with the genioplasty, would give your face more of a feminine heart shape to it.
Dr. Barry Eppley