Q: Dr. Eppley, I see you prefer to secure your chin implants with screws. I’ve searched all over my area for a doctor who does this and can’t find a single one. Do you know why this is? Is it inexperience? Is there some added risk of using screws of which I’m unaware? Do you ever do them without screw fixation? What about those who secure with sutures… what does that even mean? Thanks for your time.
A: Fixation of chin implants is done by various methods by different surgeons. By far the most common technique is the use of sutures where it is passed through the implant and done to the lining on or around the bone. One can have a debate about how secure this makes chin implants but this method highly depends on the size of the implant pocket to control asymmetry caused by a tilt in the left-to-right axis of the implant’s placement. Suture fixation can not control the potential for tilt from a single central point. Screw fixation is the most secure method and is really simple and quick to do…if one is familiar with doing it. Having done craniomaxillofacial surgery for decades this makes the use of screws for chin implants as familiar as using suture to close the wound.
Dr. Barry Eppley