Can My Crooked Chin Implant Be Fixed?

Q: I have a chin implant placed crooked (right side is out and left side is in).  I had 2 revisions by the same doctor through the same incision under the chin.  The doctor argued that I have face asymmetry but he agreed that it is not apparent from the photo before the surgery.  Would you be able to help?

A: Asymmetry of the chin after chin implant surgery can happen for a variety of reasons, all related to the positioning of the implant. The implant can be centered off of the midline. Most chin implants have a central vertical line on them which should be matched up with the dental and facial midlines (central chin point, vertical line dropped down from the junction of the two lower central incisors) as well as the midline of the chin bone. Should this matching not be aligned, the implant may be shifted more to one side than the other causing an asymmetric chin. This is what I call a central chin asymmetry. The other reason for asymmetry can be with the wings of the implant. Today’s chin implants, particularly those made out of silicone, have very long and flexible implant wings that go fairly far back along the lower border of the jaw. Should one of these wings get folded onto itself or twisted, a bulge over the tail may occur and can cause lateral chin asymmetry. Similarly, it is also possible that the pockets dissected for these wings is at different levels along the edge of the jaw bone. (and maybe even off of it at the very end) This will cause of the sides of the chin to be less full than the other.

Given that you have had two revisions, you would think that if any of these problems existed they would have been identified and corrected. They may still exist, however, particularly in the tail of the implant which can be hard to recognize. It would also be helpful to know what type of chin implant you have in place. As it may have been modified in some fashion for fit and this may be a source of the problem as well.

Dr. Barry Eppley

Indianapolis, Indiana