Are Screws Used In Chin Augmentation?

Q: Dr. Eppley, I am interested in getting a chin augmentation surgery. I have attached a couple of photos in order to get your opinion. You had written that there is a permanent chin augmentation solution where the implants are secured by small titanium screws. Would those screws need to be replaced after ten or more years? Do they set off metal detectors? It seems that screwing the implant in makes more sense. As my chief concern is the security of the implant and its ability to withstand an occasional stiff impact. I do know some chin implants are used without screws. What is your opinion on those types? My feeling was that since they are just placed on top of the chin and not secured with anything the likelihood for them to become dislodged increases. Not sure if that is true though. Assuming that there are different types of chin implants, (some more square, some more rounded) perhaps when you see the attached photos you’ll have a better idea which one would benefit me the most. Finally, I would be remised if I did not say that being your office is in Indianapolis it seems difficult that I would fly from another state for such a procedure. The logistics alone would be difficult to for me to work around. Though being your reputation is excellent, nothing is completely out of bounds. Thanks for your time, it is very much appreciated.

A: Your photos demonstrate that you would be an excellent candidate for chin augmentation. Your chin deficiency, compared to many patients that I treat is relatively mild, but I would agree that more chin projection and a more square chin appearance would have some aesthetic benefits for you. I will do some computer imaging of that and send it to you later today.

In answer to your questions about chin implants and screw fixation, this is a technique that I have always done in the vast majority of chin implants. It is simple, quick and inexpensive to do and assures that for the lifetime of the patient the chin implant is never going to move or become dislodged. I have certainly never seen it in the 25 yeasrs that I have been doing the procedure. The screws are composed of titanium, a pure element that never degrades or corrodes or needs to be replaced. It is a non-ferromagnetic metal, which means it does not set off metal detectors nor affects MRI scans. While placing screws is not standard practice for most surgeons that place any type of facial implants, it really should be.

While being a far away patient may seem unusual, it is standard in my practice as patients fly in from all over the world every week for surgery. It is easier to do than you think and handling the logistics of how to do it efficiently is a common occurrence for my staff and surgery center.

Dr. Barry Eppley

Indianapolis, Indiana