Q: Dr. Eppley, I am interested in chin implant revision surgery. I had a chin implant placed a little over 4 years ago (I am 26 years old) because of a severe receding chin. I feel that it has always been placed in the wrong positions. Wing placed too high and Apex too low leading to too long of a face and still do not have a chin that looks normal from side view. I was wondering if I could get some information on possible consult such as fee and how much a chin implant revision surgery would be?
A: If the chin implant is positioned too low on the apex of the chin that will create a tilt of the wings upward. That will also make the vertical length of the chin longer by definition. It sounds like chin implant revision by repositioning of the chin implant back up on the bone will bring the wings back down as long as you are happy with the amount of horizontal chin projection that you now have. This would not require the use of a new chin implant unless there were other changes to your chin augmentation result that you desire.
Dr. Barry Eppley
Q: Dr. Eppley, I had a chin implant placed over a year ago that ended up with my chin being asymmetric. I had a Ct scan which showed that the implant was ‘cockeyed’ in position with the left side being much higher than the right. I then had a revision done on it and my surgeon placed a new implant but it still does not look right even though it is only one month after surgery. I am going to get another CT scan but if it shows that it is still not symmetrically placed what should I do now?
A: Chin implant displacement can occur because the implant wings are asymmetrical or the entire chin implant is positioned too high on the chin bone. Asymmetry of the implant wings has become more common today due to the widespread use of newer chin implant designs that have extensions or wings with fine feather edges. While they are of great value in creating a more natural chin appearance, particularly in men, great care must be taken to get symmetric pocket developments that are long enough to accomodate the length of the implant. Too high of an implant position is quite commonly seen with the intraoral approach for insertion. In either case, secondary correction is straightforward with implant repositioning/pocket adjustment with secure fixation of the implant to its new bony position. To do that I prefer the use of screws to assure what I have obtained in surgery forever stays that way. Why chin implant revision was not successful is most likely that a new more symmetric implant pocket was not created and the implant was securely fashioned to the bone.
Dr. Barry Eppley