Can My Asymmetric Chin Implant Be Safely Revised?

Q: Dr. Eppley,I had a chin implant done last year It was an. Omnipore medium/square implant . Immediately after the surgery I noticed asymmentry. The surgeon then suspected it was swelling and did nothing. I can definitely feel it being higher on one side than the other. Tilted angle from the middle. The surgeon says that the asymmetry is too little to do a revision for and that the outcome of a revision with the additional scarring will be too uncertain and risky. A second opinion confirmed it being placed higher on one side, but said the same thing about the outcome of a revision being uncertain. They only offered to do lipofilling on the smaller side. What do you think? Is replacing the implant the best choice in the long run or is the surgery too risky. Around here there is not much expertise in this, certainly not in polyethylene materials. I thank you in advance for replying

A:Thank you for your inquiry and detailing your chin implant issues. Fundamentally I don’t think one should confuse ‘I don’t want to or can’t do it‘ as opposed to ‘it can’t be done’. Most surgeons are not too keen on revising their own work unless they are forced to do it based on the magnitude of the problem. While it is true that in the placement of chin implants perfect symmetry is certainly not always achieved and that, in and of itself, is not rare. The real issue is not whether chin implant asymmetry exist or whether it can be corrected but how much effort does the patient what to put into that pursuit and what risks does one want to take in doing so. Porous materials like Omnipore are great biologically due to the tissue in growth IF one never has to revise or remove it. It is not a great material when that is needed and that will occur in 40% of all chin implants that are placed. It is not a question of whether your chin implant can be operated on in an effort to try and achieve better symmetry. But it requires dissecting the implant out, removing it in its entirety and then reinserting it. Besides the trauma of so doing the likelihood that the implant can be explanted intact without fracturing  is low and it is always prudent when implants of this material are revised to have a backup on hand to use, and one might make the argue that is better just to put in a new chin implant anyway. As you can now see when revising a facial implant of this material the tissue ingrowth is not an asset but a liability.

Dr. Barry Eppley

World-Renowned Plastic Surgeon