Will A Custom Jawline Implant Help Me Better Achieve My Original Aesthetic Facial Reshaping Goals?
Q: Dr. Eppley, I am hoping to replace the standard mandibular implants and chin implant with a custom wrap around vertical lengthening implant. I am a little over 3 months post op and still have a lot of swelling. The doctor that did my procedures told me that he thinks that the right mandibular implant has shifted forward. After the procedure, he told me that he didn’t use screws. He offered to do a revision and said that he would put the mandibular implant back in place and shave it (if necessary) as well as bring it as far back to my ramus as possible. Being the result I wanted was a strong (drop down) vertical lengthening to my jawline. He also “repositioned” a previous botched chin implant that had migrated and shifted upward on my chin and had caused bone resorption. He was actually supposed to replace the old chin implant with a new one (that was more squared) But, unfortunately I was told after I awoke from anesthesia, that he had decided to just use the old one I had and just repositioned it more downward. Needless to say, I’m very unhappy with this result. I’m hoping and praying that you can help me!! I have attached some pictures of the RESULT/GOALS I’m aiming for. Do you think that a custom wrap around vertical lengthening implant will get me close to my desired result? Also, would you recommend a larger more square implant, and or a sliding genioplasty?? Any recommendations by you is greatly appreciated!!
Thanks again so very much.
A: Thank you for detailing your surgical history and your current situation. First and foremost, whether it was your original surgery or any revision thereof, your desired goals based on your model pictures were never realistic. That is not going to happen with any standard or even custom jawline implant. You don’t have the facial anatomy for it. That requires a very thin face that is already skeletonized to achieve that degree of facial definition. Your original surgeon or any subsequent surgeon should have provided realistic computer facial imaging that could show what is possible with YOUR face. You can’t get someone’s else facial shape…which is basically what showing those type of ideal facial shapes is trying to achieve.
Secondly most facial implants revisions or replacements require a 3D CT scan in my experience so the exact placement of the implant can be known. From that better implant positioning can be obtained ad/or new implants made that will have an improved facial result. You don’t guess or eyeball facial implant revisions/replacements…that is a recipe for just creating ongoing aesthetic problems.
Dr. Barry Eppley