What Type Of Chin Implant Revision Do I Need?

Q: Dr. Eppley, I have done a lot of research regarding chin implant revision and your name keeps popping up. I have a very weak jaw line/chin and I have a medium middleman chin implant placed with the wings cut off. The surgeon had to go back in three times intraorally to fix protruding wings and misplacement. The implant is still very high up and pushing my bottom lip up. I also have permanent muscle damage to my lip. I have denting and scarring in my chin. My last surgery was 6 months ago. I would like my neck to be tighter along with a new implant. I would also like to see if a revision rhinoplasty would fit in my budget. I had nose surgery about two years ago. The surgeon performed a pinch rhino when I’m more concerned about the bump in my nose. It still looks quite bulbous, I would like a small petite nose. I have attached several pictures and the web page called real self with other pics and doctor’s comments. Thank you for your time.

A: From a chin implant revision standpoint, intraoral placement if not placed in the proper position low on the chin bone and screwed in, has a high risk of riding up high in the chin. To properly revise this implant, the questions are whether to keep this existing implant and properly position it (ideally now from a submental approach) or to change the implant to a different style. Since you have never had a proper assessment of what this implant offers due to its many revisions and still high position, that may be a hard judgment for you to make. I would suggest a submental approach with a new implant altogether, removing the old one at the same time.

From a nose standpoint, there is certainly room for improvement from both a better hump reduction and a shorter, thinner and slightly more uplifted tip with a revisional rhinoplasty. I have attached some imaging to show what I think can be done from where you are now.

Dr. Barry Eppley

Indianapolis, Indiana