Does My Chin Implant Have Capsular Contracture?

Q: Dr. Eppley ,I previously had a chin implant that initially created vertical elongation, but over time the contour has become rounded and anterior. I’m concerned about capsular contracture or bone remodeling and want an evaluation comparing implant revision versus sliding genioplasty. I loved how my implant looked at first, but over time I believe the shape has changed.

A:What you are experiencing is a normal phenomenon that most patients are completely unaware. First and foremost almost all standard chin implants have a round and bulbous shape to them and they are usually placed on the front edge of the bone. It takes a long time after surgery to truly see the final chin shape because of the unrecognized shrink wrap effect of the overlying soft tissues. This is why it can take a year or longer to see these details  as eventually the chin assumes the shape just  like of the implant that sits underneath it.. which in some patients can like a bump on the bone. This effect has nothing to do with capsular contracture which does not occur in facial implants because they are not meant to be a movable and flexible structure like an implant is in the breast. Nor is it due to bone remodeling. In short this is due to the actual shape of the implant being seen long-term over time.

The first step to do to determine what your best options are as to understand fully the shape size and location of the implant on the bone.  Never guess what is going on underneath or make judgments out what one should do based on an external appearance The needed information requires a 3-D CT scan which will clearly show this information. Then you can evaluate the options of replacement with a custom chin implant or a sliding genioplasty.

Dr. Barry Eppley

World-Renowned Plastic Surgeon