Q: Dr. Eppley, I had a Mittleman chin implant three weeks ago via a submental incision. It initially looked to me despite the swelling and had no sigs of infection. I had some lip numbness on both sides and occasional shooting/electric shots on the chin during the second week after surgery. But all of his has been improving but I am still having pain in the right lower lip as if the “lip is split vertically. I also have some occasional drooling from the right from the right corner of my mouth. Pain is worse when I open my mouth.
Do you ever find a CT helpful to confirm good implant placement without nerve impingement? I am willing to wait a little longer but if these symptoms do not improve I would consider removal of the implant, possibly shaving down the right wing to make it more narrow and make sure to free any potential nerve impingement. This could just be a nerve traction injury resolving, but I don’t want to miss true nerve impingement if that needs to be addressed given the asymmetry in symptoms at this point.
Have you experienced this before and how have you handled this?
Thanks for your help and guidance!
A: I believe you have already answered your own question…remove any doubt about the position of the chin implant and get a 3D CT scan. That will unequivocally answer the question of potential implant impingement on the nerve. A Cone Beam scan (CBCT) of the mandible can be obtained at a local dental or oral surgery office (just search under Cone Beam scan and you find where to have it done locally) for less than $200. Such a scan will put both you and the surgeon at ease with whatever the management strategy is determined to be. (time vs implant adjustment)
Dr. Barry Eppley