Definite Chin Revision (Implant Crooked): Mid Face Lift or Cheek implant/ Lower Eye Lift? Don't want fat transfer/filler.(photo)

Due to a recent -40lb+ weight loss & aging, my face has lost a lot of volume. I have a 10yr old chin implant that is crooked, that I'd like replaced with a smaller one. I'm also considering cheek implants or a very conservative mid face lift/cheek lift. **Temp. Fillers are too expensive, Perm. Fillers are too risky and Fat Transfers would involve lipo (I'm too thin and do not want to risk skin dimpling, irregularities, etc. on my body. Advice on procedures needed Please? I'm 41 yrs old.

Doctor Answers 9

Face

Chin implant revision secured with screws so it doesn't shift over time(especially considering you are downsizing and the pocket will be bigger than desired), cheek/malar implant will add volume and help with a mid face lift by adding projection.

Chin and Cheek Implants

Your chin implant needs to be repositioned and secured by double screws to prevent re-shifting. Your midface would be better served by extended cheek implants to restore volume and provide a midface lift all along the zygomatic arch region.

Chin Implant Revision, Mid Face Lift or Cheek implant/ Lower Eye Lift? Don't want fat transfer/filler.

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties.  From the photos your cheeks are flat anteriorly (in the front), there are no jowls present and the chin is weak and crooked.  There doesn't appear to be any lower yelled fat bags but there is a slight indentation in the upper cheek bone itself.  These factors combine to create an elongated, rectangular shaped face.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  The cheek implant is placed over the cheek bone up to about 4mm's from the lower edge of your eye socket which should help cover the indentation mentioned above.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.  It's always possible that the crooked aspect, of your chin, is being caused by some bone erosion or added bone growth below the old chin implant.  It's best to find out either way with an XRAY.

 You do not appear to have "jowls” which are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.  I have included information below for comparison of how facelifts are designed to reduce the appearance of jowls.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Fat transfer

I would recommend a revision of your chin implant, fat transfer to the cheeks and nasolabial folds, and a conservative upper eyelid bleph.  The fat grafting is very safe, has the potential for a long lasting result especially in younger patients and has minimal effects on the donor site.  Best wishes, Dr. T. 

Mid-face lift or cheek implants?

Thank you for asking about your chin and cheek implants or mid-face lift.
  • I agree with your analysis -
  • Correcting the chin implant position is important.
  • I hope it is a silicone implant, not medpore, since correction is much easier with silicone.
  • You have a lovely face - cheek implants will replace the soft tissue volume you lost with weight loss.
  • I do not think you need a mid-face lift - I think you need to volume of an implant.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Facial rejuvenation

Hello and thank you for your question.   I recommend a medpor chin implant replacement which should be placed with screw fixation to ensure it will no undergo malrotation, as silicone chin implants often do.  You could also has medpor malar implants with screw fixation.  A minor midface lift could also provide added volume.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 78 reviews

Chin and cheek implant candidate

If a chin implant is in place, and needs to be placed,  it can be removed and the new one placed in the proper position. Cheek implants are placed for patients who have  a flat cheek profile and desire volume restoration to the mid- face. We do not perform a mid-facelift for a variety of reasons. Cheek implants are manufactured in a large  variety  of shapes and sizes, just like chin implants are. In our practice, we use Implantech Silastic cheek and chin implants for the last 25 years with an excellent success rate. Chin implants are placed through small incision underneath the chin, while cheek implants are placed through intraoral incisions.  For more information  and many before and after cheek and chin implant results,  pleased see link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Definite Chin Revision (Implant Crooked): Mid Face Lift or Cheek implant/ Lower Eye Lift?

Congratulations on you recent weight loss. I would certainly agree that the chin implant needs to be replaced and repositioned. Loss of volume to the mid-face is the most common reason for the "gaunt" appearance you describe. Cheek implants can achieve some volume restoration however fat transfer is still the "gold standard" for volume restoration. A combination of cheek implants combined with a very small fat transfer would probably give the overall best result. An in-person consultation is the best way to say for certain what your options wold be.

Facial Rejuvenation

I agree that a revision to your chin implant is necessary to give your chin a more symmetric appearance though I'd have to examine you personally to be sure. Regarding facial volume loss, if you really don't want fat grafting, your best option would be malar implants. I'd recommend a combination malar / submalar implant to give you the look you desire. I'd also discuss small volume fat grafting since it would be very unlikely to leave any unwanted irregularities on your body, but it would allow for the contouring of areas that won't be effected by the implants.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.