Would A Chin Implant Revision Be Successful In My Case?

Q: Dr. Eppley, I had an Implantech anatomical size small chin implant placed last year. It was placed off center and it is very noticeable. I had a sliding genioplasty more than ten years ago. The doctor blames my crooked implant on the brackets. He injected Juvaderm a few weeks ago on the left to make it look less crooked. It didn’t work. I like the height of the profile and the projection but from a front view it looks really bad. Do you think the vertically lengthening implant will also cover my prejowl sulcus and not look too boxy.

A: Thank you for sending your pictures and x-rays. Trying to place a standard chin implant on a bone based that is irregular is always a recipe for further aesthetic issues. if you look at your x-ray you can see that your original sliding genioplasty has uneven bone cuts on both sides. This combined with the indwelling metal plate and screws makes for an irregular bone surface to place any implant. While a chin implant can still be done it requires removing the existing plate and screws (if not overgrown with bone), shaving the sides of the chin bone to make it even and then placing an implant.

Trying to use an implant to cover up the prejowl sulcus or bony indentation from the sliding genioplasty, by definition, will make your chin wider.

Those comments aside before you do any further surgery you should have a 3D CT scan done on your chin/lower jaw (CBCT scan) so that it is very clear what the bone, metal hardware and current chin implant look like and how they all translate to your outer appearance. One should not guess or eyeball it when the the bony anatomy has been previously altered. You are proof of what seems like a simple chin augmentation procedure can create an ‘unexpected’ asymmetric result.

Dr. Barry Eppley
Indianapolis, Indiana