Q: Dr. Eppley, I am wanting chin reshaping surgery to get rid of my prominent square chin which is not a good look for a woman. If possible, please give me some indications on the following questions.
1) How long before I could go to work? I don’t mind being a little black and blue. More concerned about pain and my ability to focus on things.
2) How soon could I fly after the intraoral surgery?
3) How soon could I drink liquids? Eat solids?
4) Would I need to bring a companion?
5) I assume you detach and reattach the muscles immediately under the chin.
Also, I wanted to let you know that rather than a smooth curved chin, I would like the square to just be made narrower and the asymmtery in length of chin to be corrected in favor of the shorter side, but no shorter of a chin than that. I think a slight square (albeit narrower) is more interesting than a perfect oval.
A: In answer to your questions:
1) For just the intraoral chin contouring, this is a fairly simple and uncomplicated procedure. There will be sone chin swelling but almost never any bruising. The chin will be more numb that it will be painful for awhile. I certainly think you can be back to work in less than a week. There are no restrictions of amy kind after surgery.
2) You could return home the next day.
3) You can eat and drink immediately after surgery.
4) Most out of town patients come by themselves. We just have to have one of our nurses take you back to your hotel from the recovery room. We can not just push you out into the parking lot on your own right after surgery.
5) No muscles are ever deattached from under the chin. The mentalis muscle is elevated to access the chin bone are to be reduced and then reattached at the end of the bony contouring. This muscles sits in front of the chin not beneath it.
In regards to chin contouring, I would agree that in your case and face that a more narrow but slightly still square chin is better than a perfectly oval shaped chin.
Dr. Barry Eppley
Q: I am interested in correcting some asymmetry in my face and creating more harmony to the lower third of my face. The back of my lower jaw area (masseter muscle) is bigger on my right side. There is also some soft tissue asymmetry with the right side being fuller in my mid cheek area, and my chin is off center. I have been to different cosmetic surgeons but have not come across anyone who has a real solution for this. Orthognatic surgery was recommended, however I believe there is a way to correct this without such invasive surgery. I have had trouble locating a doctor in my town that does jaw implants, that’s why I was happy to find your site because it seems jaw angle implants and dealing with facial asymmetry and the jaw area in general is something you have extensive experience. I have done some research, and the solution I came up with would be jaw angle implants, with the one on the right side being bigger to account for the asymmetry. However, even without the asymmetry I would still be considering jaw implants, just because I feel that my jawline is more narrow/less defined than I would like. For the soft tissue asymmetry I would like to do removal of the buccal fat pad/or facial liposuction to thin out the lower cheek area of my face and make that area more defined. Please let me know what you think. I look forward to hearing from you and getting an idea of what you think is best from the imaging. Thanks!
A: Thank you for your inquiry and sending your photos. As you have astutely pointed out, you have overall lower facial asymmetry marked by a very high left mandibular angle (steep mandibular plane) compared to the right side and chin bone asymmetry. This could be improved by jaw angle implants (3mm lateral style on right and 3mm inferolateral style on left) and chin bony contouring. (right chin tubercle reduction) For the midface, I would look at not only buccal lipectomies but the addition of small cheek implants as well. When you have a long face that is flatter in profile (malar hypoplasia), some anterior projection of the cheeks is helpful. Otherwise, buccal lipectomies alone may just make you look a little more sallow or gaunt and not provide the facial highlighting that you desire.
Dr. Barry Eppley