Chin Implant Revision

Q: Dr. Eppley, I had a chin implant placed through a submental incision three months ago.  I’m really in a tough spot with the chin implant because I really can’t live with this crooked smile I’ve had since post op, but no doctor knows what’s causing it or how to correct it.  I’m seriously thinking of removing it without replacement in the hope that my smile will return, but I have concerns about post removal complications like witches chin deformity or scar tissue balling.  If I remove it, it will be five to six months post op at the earliest. This was a large extended anatomical implant, and I’ve read doctor opinions on Real Self where they’ve expressed concerns about removing a large implant without replacement more than a few months post op.  What is your take on all this?  Should I only have a doctor perform this procedure if he does it a certain way?  For example, only go with a plastic surgeon that can recognize, during surgery, if a submental tuck up is needed, as well as one that has me wear a chin compression sling post op?  I wonder too if, since my jaw is on the smaller side, could this implant be ‘too tall’ and be limiting my mentalis muscle, in turn affecting my smile? If I were to go with another implant, should I be sure the doctor’s comfortable shaving it down to be no taller than say 1.0cm or even less than that? The large Terino implant is 1.3cm at its tallest point in the center.  Please see the 2 attached 2 X-ray’s taken recently if they are of any help in your assessment.Thanks for your help!

A: With a chin implant that is only adding 6mms of horizontal projection, I would have no great concerns that removing it would create a witch’s chin deformity or a chin ptosis. If the implant is removed I would see no reason that a submental tuck would be needed. Simply putting back and tightening the mentalis muscle should be enough.  When trying to solve a problem, don’t complicate it by adding too many variables. Either simply remove the implant or have the one you have now repositioned a bit lower on the bone. It is sitting just a tad high on the bone right now. While that may or may not solve issues, these are simple chin implant revision maneuvers that at the least will not create any further complications.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry L. Eppley
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Board Certified Plastic Surgeon