Can The Plates and Screws From My Prior Chin Surgery Be Removed?
Q: Dr. Eppley, About 9 years ago I had a chin reduction in which they used a titanium plate and screws to hold it together. These screws and plate were not removed. I’ve had some complications and just don’t want them in my body anymore. I had a few questions for you.
1. Is it possible to remove the hardware after 9 years? And is it possible to remove all of it?
2. If the bone has over grown on the hardware can it be removed to rechieve the hardware?
3. Would you put biodegrable screws in to fill the area or would the bone be strong enough by now even if the hardware is removed?
4. Is this a hard procedure or have you done this before?
5. What is the longest someone has had the hardware in for and were you able to extract all of it?
I am trying to receive my x-rays from my local dentist to show you but hoping you could answer these questions for me. Thank you for your help
A: Thank you for your inquiry. In answer to your questions about chin fixation removal:
1) Whether hardware has been in the chin for 9 months, 9 or19 years, its removal is possible. The ability for it to be completely removed is not dependent on time of implantation. It is actually dependent on whether the screw heads have been stripped during their placement.
2) One can safely assume that bone has overgrown much of the hardware, this is common and predictable. The overlying bone growth can be removed and the hardware exposed.
3) Your bone is well healed and strong enough that it not longer needs the indwelling fixation you have or any need further fixation once it is removed.
4) I have removed fixation hardware all of the craniofacial skeleton many many times over the past 30 years, the chin bone is no exception. When you do a lot of chin osteotomy revisions managing the indwelling hardware is just part of it.
5) I once took a fixation plate out of a 78 year old lady’s lower jaw that was initially placed to fix a fracture in 1972. She has lost enough bone height from not having teeth that the plate became eventually exposed.
Getting an old or recent panorex x-ray would be helpful to see the type of the screw heads that were used. That way one has the right type of screwdriver available that will fit the screws.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.