What Type Of Chin Implant Revision Do I Need?
Q: Dr. Eppley, I had a medium anatomical silicone implant inserted under my chin along with liposuction of my jawline two months ago. I know I’m still healing but I just don’t think there will be enough change to make me happy. My chin feels too long. I can’t tell if it’s placed to low or could it be my anatomy? I feel like I had a really recessed chin so I can’t tell if my feelings are just the fact I’m used to looking at myself with one. It just doesn’t seem to flow with my face and really sticks out now when I smile. I would like a revision but very scared about how it would turn out. This has been a very emotional experience and it’s hard to not recognize your own reflection. I feel like I’ve lost my femininity. I’m not sure what style and size implant would suit me better. I had a very narrow chin before. I now have a more prominent mental crease that’s always visible. I was aware of the crease before the surgery but it was only if I made certain faces and such. I added before and after pics, there is no questioning which is which.
A:Thank you for sending all your before and after pictures. I don’t think there is any question that the chin implant result does not fit your face. Your chin has become wider and longer with a 45 degree angulation of chin augmentation. This usually occurs on backward sloping small chins (yours) where the implant is placed where it is supposed to be placed on the bottom edge of the bone. But because the bone is angled downward in chins like yours, such placement ends up losing some of the horizontal effect and inadvertently creates length. (rather than completely horizontal effect it becomes a combined horizontal and vertical effect…the so called 45 degree chin angulation. (see attached pic) Your chin is also wider because of the anatomical extended wing design. By definition this makes every chin wider, which is great for most men, but not for most women. (see attached pic) The implant has done what it is supposed to do by filling int the prejowl area but this also makes the chin wider. There are a lot of women who need end up the same problem (wider chin) when this chin implant style is chosen. It is a a good chin implant just not a good one for women with small narrow chins.
Your options at the point are to swap out the implant for a central style that sits a little higher up on the bone (chin implant revision) or a sliding genioplasty which moves the chin forward and up as well as keeps it narrow.
Dr. Barry Eppley