Chin Implant Revision

Q: Dr. Eppley, I am considering chin implant revision. I got an Implantech medium anatomical chin implant through a submental approach six months ago.

Before I list my questions/concerns, I would like to say I’m extremely happy with the way the implant looks and prefer to keep it than to remove it but the tightness on the right side of my lower lip is very bothersome.  I received a few doses of Botox to see if it would relieve the tightness and it has but I’m afraid this is only masking the feeling and not really taking care of the problem.  I would love to think it would solve the problem with the tightness but I know Botox is only a temporary fix.  And I wouldn’t want to wait too much longer as I feel my nerve might be compressed and have some hope perhaps I could get some feeling back and relief of the tightness if I were to remove it.  The reason I think I’m hopeful on my nerve having some feeling back is because when I stretch my mouth downward (as if I were yawning), I feel immediate relief.  Also, when I push the right side of my lip outward with my tongue, I feel lots of tingling on my right lower lip as if there was still some nerve messaging going on there. 

This is why I needed a second opinion on what I should do.  I’ve heard of numbness sometimes being permanent but is this true with tightness as well?  If I were to remove the chin implant, will the recovery be as when I put the implant in?  Can tightness still be a problem even after removal?  Does scar tissue cause problems after removal?

Thank you for your time and consideration as this has been an emotional rollercoaster for me.  I don’t think I can go through a revision either as I have heard that those who have had it done usually opt to remove it anyhow due to other issues.  I appreciate any guidance. 

A: Thank you for supplying your additional information. The most important thing to know with your symptoms and considering a chin implant revision  is what is the actual position of the implant on the bone. Is the implant placed symmetrically? Is an implant wing up against the mental nerve? Are your symptoms due to the implant position or just from the soft tissue alone? Your symptom description implies the former.

Tightness issues can be different than nerve issues but it is important to know where the implant is actually sitting on the bone which can only be obtained from a 3D CT scan. If you didn’t like the aesthetics of the chin implant then such a study would be irrelevant. But since you do, first establishing that the implant is in a good and symmetric position and its wight wing is not compressing up against the mental nerve would be a critical piece of information in how to proceed.

Dr. Barry Eppley
Indianapolis, Indiana