The custom chin implant is the most assured form of augmentation of the lower anterior third of the face. This approach is particularly needed when a specific chin size or shape is desired. Given the unique shape requirements of a square chin shape and the lack of a really effective standard square chin implant a custom design is the best way to get an assured square chin augmentation.
Having made many square chin shapes for isolated chin or for a total jawline augmentation the effects are quite profound. But I had a case recently where a very large and square chin implant resulted in a right-sided asymmetry/deficiency. It was like the left side of the chin was missing. Intraoperatively the implant was placed perfectly level to the bone and was secured with three long screws. A postop 3D CT scan showed good placement with no asymmetry.
In deciding how to address the implant asymmetry it did not make good sense to create a new custom implant design given how well the current implant was placed with a symmetric square shape.It seemed more prudent to add some implant material to the left side of the chin as an overlay. The question then is what material and its shape should be added. Fortunately I had a duplicate implant from a prior patient’s square chin implant design and taking a corner from this implant for the add-on. This would provide the best shape to the deficient square chin implant corner.
Through the existing submental incision a section of implant shaved off of its left corner was used as the left implant overlay. It was secured with sutures to the underlying implant.
The improvement in the chin asymmetry was immediately apparent. The change was remarkable given that the overlay implant material was so thin.
Dr. Barry Eppley
World-Renowned Plastic Surgeon