Q: Dr. Eppley, I got a 7mm Medpor Chin Implant put in on January 20, and I want it removed ASAP. Its too bulky and makes my face look less feminine than before. What are the chances of my face going back to the way it was before? Would another implant need to be put in? my doctor doesn’t do silicone chin implants for their tendency to drop overtime so Medpor it was. I’ve heard how difficult these implants can be to remove, what’s your experience with removing them? If I was to replace with a silicone implant, is it better to do it when removing the other or a few months later?
A: I am not surprised that a Medpor implant is too bulky for a female. While that implant needs to be removed, it is important to always remember that you had a chin implant placed for a reason and that was to correct a chin deficiency. This may be the wrong implant but that does not mean that there is no merit to having a chin implant at all. A better shaped and more feminine chin implant made from silicone would offer horizontal advancement with far less width if any at all. I would strongly consider replacing the implant rather than merely removing it. I have to see you throw away the complete effort.
I have removed many Medpor implants. While they are not as easy to remove as silicone it can be done. I have never heard of silicone implants ‘dropping over time’. There jus no biologic explanation for that and something I have never seen. It is better to remove and replace at the same time (with screw fixation of the new silicone implant) than to delay. The only reason to delay/stage it is if you are uncertain that you really want an implant at all. But that will change what is done during the implant removal. If you are just removing then you need to do a submental tightening of tissues since the tissues have been expanded to avoid a chin pad drop/ptosis.That ail not be necessary with a chin implant replacement.
Dr. Barry Eppley
Q: Dr. Eppley, I’ve seen you on real self and seems like you are great with chin implants/surgery. I’ve had a consult with a couple other surgeons…one of them imaged my chin too big. The pic looked ridiculous! I’m wanting to know what you recommend for a female chin augmentation like myself. The other surgeon suggested a 2 or 3 mm implant. I have a chin dimple also. Would the chin implant cover the dimple? If so that would be great because I don’t like the cleft. Thank you!
A: The key to your female chin augmentation, which is not rare for females, is to not use a male chin implant approach. Your chin needs about 3mm (maybe 4mm) horizontal AND some vertical increase as well. That will work best with your vertically shorter total facial height adding more total facial length in a subtle fashion. In addition chin implant should not be round but have a more tapered shape to it to keep the new chin ‘slim’. The chin implant may push out the chin dimple/cleft but I wouldn’t count on it. It is best supplemented with a small amount of injected fat right into the dimple at the same time.
Dr. Barry Eppley
Q: Dr. Eppley, I am a 37 year old male. I have been feminizing my face for the last few years. I’ve already had my brows shaved and my hairline brought down. I wonder if you can help with 2 other areas that trouble me.
(1) I used to have a narrow, pointed chin. Unfortunately I had it shaved flat. Then I had a shaved medpor medium sized anatomical implant inserted. But my chin still looks wide, rounded (not pointed) and too long.
I have read a lot about you. I understand that you can use a smaller implant and shave the wings off to make it more narrow, and shave the point of the implant to be more pointed and shorter.
I have enclosed a photo of how it used to look, which I liked, and how it looks now which I don’t like.
(2) I also had high and narrow cheek implants inserted. Unfortunately the left implant became displaced after a car accident
and then removed. So now I only have the right implant in.
I wondered if you could place feminine implants in to replace the cheek implant i already have.
A: In looking at your chin and cheeks and your accompanying commentary, I can offer the following recommendations:
1) Your chin is now broader and more masculine than it was because of the use of an anatomical chin implant design. The Medpor chin implants have very broad wings that add fullness to the side of the chin making it wider. That could be changed by either altering the implant you have in place (difficult to do because of the material) or remove and replace it with a more central button implant style which will return the chin to more or of a triangular shape. The length of the chin may just be a function of the size and location of the indwelling implant. But if some real vertical chin shortening is needed, the lower edge of the chin bone will need to be reduced.
2) The cheek implants you have in place produce a more sculpted male look being high and lateral. A more feminine cheek appearance requires a rounded more anterior cheek look. That could be achieved by replacing the cheek implants you have in now with those that are better shaped for that look.
Dr. Barry Eppley