Will A Substantial Vertical Chin Lengthening Help Deround My Face?

Q: Dr. Eppley, I’ve always struggled with insecurity about my facial structure — especially the roundness of my face. Despite being healthy and at a low body fat percentage, I’ve always had a “baby face” appearance that doesn’t reflect how I feel internally. About 7–8 months ago, I underwent chin implant surgery and neck liposuction. The neck contour has improved significantly and I’m happy with that outcome, but the chin implant didn’t give me the downward/vertical length I was hoping for. While it added decent projection, it didn’t structurally elongate my face the way I envisioned. I’ve done a lot of research and I truly believe that a downward and narrowed sliding genioplasty (9–11mm) combined with aggressive buccal fat removal would finally give me the definition and structure I’ve always wanted. I’m aiming for a more angular, masculine V-line — with sucked-in cheeks and better lower-third harmony. I also value facial balance and would prefer 3D imaging or planning if possible. I’d really appreciate the opportunity to discuss this with you directly and hear your thoughts on what’s realistically achievable in my case. If you’d like, I can provide photos and my previous op report for context. Thank you so much for your time.

A: Thank you for sending your pictures and detailing your previous facial surgery. Besides the lack of any vertical lengthening the extended wings of the current implant also make it wider than your original chin. These two chin implant issues work against derounding your face. I would agree that a bony genioplasty that provides vertical lengthening and horizontal projection and makes the chin more narrow wil do better in derounding your face.

The combination of chin lengthening and cheek soft tissue reduction is always synergestic at derounding the face.

A few caveats:

1) I would doubt that 10mms or moreof vertical lengthening is what is needed. More likely it would be in the 6 to 8mm range.

2) You can keep the chin implant attached to the bone to maintain horizontal projection although the wings of the implant need to be removed. When vertically lengthening a chin with an implant in place the downward movement of the bone allows the implant to add some vertical lengthening as well.

3)A maximal cheek defatting requires a combination buccal lipectomy and perioral liposuction.

Dr. Barry Eppley

World-Renowned Plastic Surgeon