What Are The Potential Aesthetic Downsides to Temporal Implants, Zygomatic Arch Implants and Vertical Chin Reduction?
Q: Dr. Eppley, I have questions about the three operations I will be having. What are the downsides of any of these three procedures (temporal implants, lateral cheek implants, chin reduction)? And percentage frequency of the downsides? Is there any chance the implants would not look natural? Do they look as good as fillers?
I heard once, and it may not make any sense, that injections of saline can give a good idea about how fillers or implants might look, and then a person can make a decision about implants. Is that true? Is there anything else that might work this way to give an idea that might last only several hours or a day?
Are you confident that you can obtain at least 7 mm reduction in chin length (hopefully more)If you are not certain of this then I don’t believe I would go forward unless would be certain that with five or 6 mm it would make a significant difference ——I am not interested in just a little better or slightly noticeable in its effect on the entire face. I definitely would want 10 millimeters or 1 cm, which is only 2/5 of an inch. In real life, when this is done, is this a lot? Does it usually make a noticeable difference? Will this change the shape of the chin? Do you grind it down with a machine?
Will the scar necessary for the temporal implant be noticeable? If it is behind the hairline, will it change the hairline or be a noticeable scar underneath?Same question for cheek implant.
What are the chances of the implants moving, or shifting, or getting bumpy to where they would have to be replaced?
You may have answered this question, and I apologize if you already have, but is it possible that the temporal implant will erode the muscle or the bone?
How long will the implants last?
Would you have to do any filler around it?
Regarding the possibility of the lateral cheek implant to widen the face, does that look natural or a little strange or different?
Will that significantly widen the face or just a little bit?
When I am very pleased and confident with my face when I change to a wide mirror, obviously, the entire face is widened, including the area from where the jawline begins to the chin. Of course we don’t want to widen this, but I wonder if that will be problematic in terms of the overall look of the wider face I am seeking.
If I go forward with the lateral cheek implant and that fails, and there is some redundant skin, can filler be used as a backup that would look good if needed?
If I hold off on doing the lateral check implant and want to do some injections 1st to see, can the lateral cheek implants be done under local? that really helps with the cost.
Can I go back the next day? Any particular work restrictions as long as I’m okay with the swelling? Any big bandages on the chin?
How many of each of these three procedures have you done over the last year, and since your career? I would suspect because you are board-certified in both maxillofacial and plastic surgery, that you have done many.
Thanks very much and hopefully no more, not too many more questions
A: Like all procedures there are downsides/risks…which is what I think you are asking. Having done a lot of all three procedures I would say that the only real major aesthetic downsides are as follows:
1) Temporal implants – least risky of them all and completely reversible. The question is how much is enough and what is too much augmentation?
2) Zygomatic Arch Implants – effective but can be tricky to get perfect symmetry…but still reversible.
3) Vertical Chin Reduction – I think the question here is given the amount of bone that can be reduced, is this enough
The only solace I take from #3 is that #1 and #2 help with the overall appearance change. In other words, widening the temples/midface works in concert with the chin reduction to help make the face appear vertically shorter.(diametric movements)
I think with the implants there if very little risk of looking overdone. I worry more about not enough than overdone. As a general rule, implants usually look better than fillers and have a more pronounced effect.
You can try saline injections, and they don’t really create the effect of the implants, but they will at least do something. (a thin liquid can never create the same tissue push as a more firm implant)
Most vertical chin reduction by intraoral wedge osteotomy remove in the 7mm range of vertical bone height. A panorex x-ray is needed to measure how much bone can be safely removed based on the location of the tooth roots and the mental nerve exit.
While the chin shape will change if someone has a more pointy chin (will get more flat or square) yours is already so…so in your case I don’t envision any significant chin shape change.
The temporal implant is put in with an incision behind the ear so it is scarless.
I have never seen temporal or zygomatic arch implants move/migrate. They are very smooth so they will not cause an irregular outer contour. Again symmetry is the issue here.
The temporal implant is a muscular implant which is unique amongst facial implants. It sits on top the muscle underneath the fascia. Muscle erosion is not an issue of concern.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.