What Is The Best Way To Restore My Lost Chin Length?

Q: Dr. Eppley, I hope you wouldn’t mind giving me some advice/thoughts. In 2022 I had bilateral gonial angle reduction and a bit of excess bone from middle of chin shaved off. Very happy with gonial angle reduction but the improvement in my front view wasn’t what I was hoping for.

Consulted a surgeon this year and underwent chin reduction – he cut 5mm off the chin point and narrowed it. Unfortunately, I’m very regretful of this, feeling like I needed that extra length to balance my face and feel chin looks too short and round. It is early after surgery and I still have some submental swelling. Aware I need to let things settle physically and mentally, however I have a few queries.

1. When would be a good time to have a repeat CBCT post surgery? ‘m keen to see what exact changes where made and where on the mandible and what can be done to restore my chin as closely to what it previously was.

2. Would a vertical lengthening genioplasty be an option? My original surgeon offered dermal filler.

3. What are your thoughts on custom made chin implants to restore the original shape and length of the chin? Would these be made using exact measurement differences of the bone from the pre and post surgery CT scans? I am 30 years old and healthy, would I likely need a repeat procedure in future if i was to get an implant?

Psychologically, I feel I prefer the permanent aspect of the genioplasty and the fact it is ‘replacing’ what I’ve taken off – bone. Appreciate I can’t turn back time and struggling with regret.

4. I am concerned, although have recovered well, about future intraoral incisions and effect on the mentalis muscle. Can a vertical lengthening genioplasty be done submentally?

I have included some photos. Many thanks for reading, and thank you for the information you share on your website, it has been by far my most helpful and informative source recently.

A: In answer to your questions:

1) Anytime is OK to get a 3D CT scan of your chin/lower jaw. The bone shape is not going to change with more healing time.

2) The only autologous approach to improvement would be a vertical lengthening genioplasty. I do not know how the previous reduction was done but the 3D scan will make that clear.

3) A custom chin implant is the non-autologous option as long as one can accept an implant to do it. Such implants are permanent., Unless you had a pre-reduction 3D CT scan that can be matched to the postop 3D CT scan there would be no way to know exactly how to do the ‘perfect’ restoration froma dimensionally standpoint. This applies to a vertical lengthening genioplasty as well.

4) The vertical lengthening bony genioplasty can not be done from a submental approach, only a custom chin implant can.

Dr. Barry Eppley

World-Renowned Plastic Surgeon