Q: Dr. Eppley, I feel my face is a little weak down around my jawline area. Iwas hoping to have a more masculine jaw with out elongating my face any more… just maybe make it more full. Also as you can see on my photographs, my face is very asymmetrical. My right temple seems sunken in so was researching your page and saw you have a temporal implant, was wondering if I good candidate for the procedure. And last but not least, my nose is also very asymmetrical. If I feel above the nostril I can feel more cartilage on the left side of the nose and my right doesn’t have any. I am open to suggestions please if you can let me know the procedure you believe I will benefit from.
A: From a jawline standpoint, there is a clear chin deficiency but with a slightly long (rotated backwards) chin as well. While an implant can be used and probably not lengthen the chin, the most ideal treatment is an osteoplastic genioplasty where the chin can be brought forward and shortened as well. I have imaged that potential change in the attached profile pictures. In addition, I have also added some small jaw angle implant in the front view to see if widening the posterior jawline is also aesthetically beneficial.
As for your nose, I can see a slight retraction of the alar rim upward creating nostril asymmetry. That would also account for the differences you feel in the lower alar cartilages in the tip of your nose. This could be improved by the addition of an alar rim/onlay graft to the right side of the tip of the nose.
As for the temple areas, I am having a hard time to seeing the amount of asymmetry between the two sides. This may be a function of the photograph. For temple asymmetry, a small subfascial temporal implant can provide a moderate amount of augmentation to the more depressed side.
Dr. Barry Eppley
What Is The Recovery And Discomfort Like After Having An Osteoplastic Genioplasty and Jaw Angle Implants?
Q: Dr. Eppley, My question is about the after surgery effects from getting jaw angle implants. I am also going to get an osteoplastic genioplasty at the same time for a complete jawline makeover. What level of pain do most patients experience and how long does the recovery and healing process typically take?
A: To answer the recovery question, it all depends on one’s definition of recovery. But if defined in terms of return to work and being in public without significant residual swelling, that is going to be in the range of 2 to 3 weeks. It could be shorter or longer based on what one does and what activities one wants to engage in. This does not mean that all swelling is gone in three weeks, just a large part of it. It takes up to three months after surgery for final swelling resolution and tissue adaptation to the implants to occur. This is as true for a chin osteotomy as it is for jaw angle implants.
From a discomfort standpoint, jaw angle implants are the most uncomfortable of all facial implants because the major chewing muscle (masseter) must be lifted up to put them in. It also affects one’s ability to chew well for a few weeks, again because of the masseter muscles being traumatized. A chin osteotomy causes more swelling than an implant and similarly takes up to three months after surgery to really see the final result.
Dr. Barry Eppley
Q: Dr. Eppley, first of all I want to say that your site is full of information and i have learned a lot of things. I want to do an osteotomy/genioplasty on my chin to achieve facial balance cause I have a receding chin. I also want to do this surgery to shorten and make my lower lip thinner. Will this surgery tighten the lip and chin musculature and will it cause my chin to look thinner? I am looking forward to hearing from you.
A: In most cases of an osteoplastic genioplasty where the chin is advanced, it will make the width of the chin thinner. This is because a chin osteotomy is like advancing the front part of an upside U forward. It is elongating the U and makes it more narrow. Whether that effect is significant or not depends on how much advancement is being done. But anything over 5 to 7mms, the thinning effect will be seen. It does not usually make the lower lip any thinner however.
Dr. Barry Eppley