What Should I Do For My Fourth Chin Implant Surgery?
Q: Dr. Eppley, I really need help and advice. About two weeks ago I had chin implant surgery for the third time. The first time was five years with a . Medpor 5mm implant. The time was in January of this year to make more volume. My surgeon desided to use a Medpor 9mm implant on top of the first one. Together it is 14mm. It was too big for my face and did not look good. I also got marks on each side of the implant. My surgery decided to operate again. I was hoping he would take both Medpor implants out and give me a new start with an implant 8 or 9mm. But he didn’t. He was afraid to inquire my nerves. So he carved to make the top implant smaller and melt them together. Now I have 10mms of implant projecion. Last operation was this past February. It feels better because of my mouth movement and is easier to speak and smile. But I still have marks on each side and my chin does not look smooth. And it doesn’t blend well together with my jaw/cheeks. I know it is still early and I have to wait. But I’m scared that the implant are the wrong ones. I may need another shape. My face looks longer and don’t like that. I really don’t know what to do now. My surgeon is one of the most qualificated in the city. And he seem nice but I have a feeling that taking both out and give me one with other shape could be the correct to do. But maybe I’m wrong… I’m so confused and sad 😔. Is there anything to do?
A: Thank you for your inquiry and detailing your surgical history. I believe you have largely answered your own question. Stacking chin implants (or any facial implant for that matter) often creates new aesthetic issues (such as the ones you have) as it is virtually impossible to not have visible transitions unless what lies above or below is very small compared to the other stacked implant. This is particularly true with Medpor implants as they do not have feathered implant edges. Your options at this point are:
1) Remove both implants and replace with the largest size available as a single implant.
2) Have the chin implant custom made. (which, of course, is always the best choice)
3) Remove both implants do a sliding genioplasty.
There is no advantage to delaying another surgery when you know another one needs to be done. Further healing time does does not help you.
Dr. Barry Eppley