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Case Study – The Extended Custom Chin Implant in Facial Deformities

 

Background: Soft tissue contractures of the face cause a variety of deformities. Even with normal underlying bone structures, loss of overlying soft tissue volume and shape can make the face appear deficient and distorted. This is most classically illustrated by burn patients who suffer the greatest amounts of soft tissue loss and deformity when suffering extensive burns to the face. But there are a variety of other diseases and medical conditions that can also cause soft tissue facial contractures.

The jawline is one of the most notable features of the lower face as it creates a clear separation of the face from the neck. Also because it is the only bone that moves on the face, its projecting prominence helps create a distinct facial profile. A more evidentĀ  lower jawline and a nicely shaped chin prominence is valued as part of a proportionate and attractive shape. Distortion of its overlying soft tissue along the bony jawline can create a distinct degree of distortion of its form including the anterior projecting chin and lips.

Case Study: This 46 year female presented with an overall facial deformity caused by a rare medical condition with extensive soft tissue deformities and scars. She had been through dozens of soft tissue procedures of the face, through excision and reconstruction, that led to her present facial state.

Extended Chin Implant design and placement Dr Barry Eppley IndianapolisCustom Extended Chin Implant result side view Dr Barry Eppley IndianapolisShe subsequently underwent a variety of reconstructive procedures including injectable fat grafting, dermal-fat grafts, lip reconstructions and an extended custom chin implant to augment the chin and the jawline behind it. The implant was designed from a 3D CT scan of the patient.

Custom Extended Chin Implant result oblique view Dr Barry Eppley IndianapolisCustom Extended Chin Implant result front view Dr Barry Eppley IndianapolisThe re-establishment of facial volume from contracture and volume loss can be aided by augmentation of the bone beneath it. While this is of value over any of the bony prominences of the face, the extent of the surface area of the jawline makes it most useful in this boundary area between the face and the neck. Such a custom chin implant serves a tissue expander to stretch out the contracted overlying soft tissues.

Highlights:

  1. Chin augmentation can include the entire length of theĀ  body of the mandible back to the angle with a custom designed chin implant
  2. Adding volume and structure along the jawline can expand the overlying soft tissue in cases of contracture and deformity.

3) Adequate chin projection and a straighter jawline improve facial proportions.

Dr. Barry Eppley

Indianapolis, Indiana

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Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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