Chin Implant Revision
Q: Dr. Eppley, I have had a Medpor chin implant placed last year. I am ok with the look although it is a bit big for my feminine small face and my chin looks a bit big and asymmetric when I smile. However my big problem is when I woke up after surgery with excrutinating pain on the right side, probably along the branch of the mental nerve that goes to the lip. And it still hurts a lot, focused on that groove between chin and lip on that side. It improves when lying down after a while and worse when I move my mouth, speak etc. What should I do?
The surgeons are very experienced but have never experienced this kind of problem before, and have never removed or performed a chin implant revision. I also have numbness in the same side of the lip and a bit problem with articulation.There is also pain in the lip when I stretch the lip. When I wake up in the morning the pain is almost gone and comes when I start moving around. I consulted a neurosurgeon who said there is nerve damage, not a cut nerve. The surgeons are willing to take out the whole thing but I think that is very drastic. What would be your advice, and where to find the best expertise for my problem, and how to fix it – the situation is kind of desperate as i do not function so well wit all that pain. Hope to hear from you soon.
A: Either the chin implant is impinging on the nerve (mental neuropraxia) or the nerves has beens stretched/injured during the making of the pocket to place the implant. Given the overall larger sizes of Medpor chin implants and their stiffness, it is likely that it is the former. I think the only way you can make improvement is to do a Medpor chin implant revision where the implant is removed, the right mental nerve checked/repaired/fat grafted and the implant modified in size and reinserted. It is unfortunate that this was not done a long time ago when an injury to the nerve had a much better chance of having a full recovery.
Dr. Barry Eppley