How Can I Improve My Jaw Shape After V Line Surgery?

Q: Dr. Eppley, I had genioplasty + bone graft for chin advancement and lengthening and jawbone osteotomy done in Korea about 11 months ago.I saw some improvements but there were a couple of unsatisfactory results:

In terms of the chin:

1. there is a bony gap now in the chin from the genioplasty

2. there is some asymmetry of the result

3. there wasn’t as big of a difference as I hoped so the chin is still recessed, and length is still not as proportionate

Jawline:

4. gonial angle is not as visible now and jawline is less prominent

I am not looking for dramatic results but was considering getting custom chin and jaw implants to address these issues to improve the results but am also open to any other options recommended that are available since I don’t need dramatic results just a good solution that will work long term to reach my aesthetic goals of:

1. more chin projection (maybe just 4mm) and addressing asymmetry (priority). This is also to make the mouth protrusion look less noticeable but would be open to jaw surgery if it is a better fit. However, After consulting multiple spots I have been told my case is not severe enough for jaw surgery and I should consider just implant, or genioplasty + orthodontics.

2. clearer jawline and angle (not as priority depending on costs)

Let me know your thoughts and what you think the available and best options are.

A:You have had prior V line surgery with the tradeoffs of too much jaw angle bone removed, bony gaps/irregularities in the chin osteotomy and desire for some additional horizontal chin projection. To make these improvements now these can not be adequately improved by further bone surgery. This would require a custom wrap around jawline implant to make all the needed improvements. In other words overlay the bone to get the increased chin projection, a more evident jawline and to smooth out the inferior border.

Such secondary V line surgeries are common in my practice. The custom design approach allows control of all desired changes preoperatively because of the 3D design process.

Dr. Barry Eppley

World-Renowned Plastic Surgeon