What Type of Chin Implant Revision Do I Need?

Q: Dr. Eppley, I had a chin implant by another surgeon several months ago. My dissatisfaction with it is with the lack of forward and downward projection. I also believe the implant is either crooked or has magnified any natural asymmetry. I am concerned that the shape of the implant is too round. My original chin was more squarish (a slight “butt chin”) and as you can see in the included picture the implant has shifted the soft tissue, making my facial hair off center. I’m not totally opposed to keeping it if this asymmetry can be fixed by the sliding genioplasty procedure, or if the implant itself can be altered.

I am also interested in what my options are for the incision scar on my neck. It is large and raised although I don’t know if the picture shows it well.

I initially raised my concerns with the size of the implant with my surgeon who said that anything more than 5mm would look “cartoonish”, because of this confident dismissal I figured he knew what he was talking about.

I am interested in using 3D imaging/scans to see exactly what my options are.

Please advise next steps.

Again, thank you for your time.

A: By definition most chin implants are round, particularly all Medpor chin implants. So anyone with a naturally more square chin is going to end up with a rounder one. That is an important preoperative discussion about chin implant selection.

All standard chin implants can only produce horizontal augmentation, not any vertical elongation. Only a sliding genioplasty or custom chin implant can increase both horizontal and vertical projection. 

How your chin implant is positioned can not be known completely from viewing the outside. Only a 3D CT scan of the mandible can provide unequivocal clarity in that regard.

The hypertrophic submental scar can be revised to be a finer line.

I will have my assistant Camille contact you to set up a virtual consultation time.

In the interim what you need to get is a CBCT or cone beam scan of your lower jaw which can be done where you live. Search that term in your local area to find a provider of it. It is a common scan used in many dental offices particularly that of oral surgeons, orthodontists and dental implantologists.

Dr. Barry Eppley

Indianapolis, Indiana