How Can The Bent Wing Of My Chin Implant Be Fixed?

Q: I had a chin implant done on 2/1/2011. It was a 7mm projection Mettleman style. The right side looks wonderful and I cannot feel the implant really at all. On the left side, however, the implant traces nicely along the edge of the jawbone until aproximately the last 8mm of the wing. At that point it swings upward at about a 40 degree angle. The wing can be felt intraorally with my finger near the bottom of my mouth on that side. Aesthetically, on that same side, there is a jowling effect. I do not know if this is due to the free floating wing or if the wing has pushed other tissue upward and created a lump or ball. My surgeon has suggested that we wait 6 weeks and then go in intraorally and either “tuck” the wing back under the periosteum or simply snip it off IF it is beyond the point of the pre-jowl sulcus, thus accomplishing the pre-op goal of filling in that area. He described it by saying that that what is now the “floor” of the pocket where the wing is malpositioned will be the “ceiling” if we tuck it back under the periostium. I believe he would suture the ceiling so as to ensure the wing doesn’t communicate with the previous pocket and again migrate north. Does this sound like a reasonable plan to you?

A: With today’s extended chin implants, exclusively those made out of silicone, the most common complication is wing malposition. The ends of the silicone implant wings are very thin and easily bent or folded onto themselves if the pocket made during surgery is not fully developed and extended enough to accommodate the full length of the implant. Because you can feel the end of the implant in the vestibule at the side of your mouth,it is bent up in that direction which also causes an implant to create a bulge in the jowl area. There are several approaches to fixing the malpositioned implant wing. The intraoral approach is one and is the easiest. The implant can also be removed, the pocket extended and replaced but involves ‘more surgery’.

Dr. Barry Eppley

Indianapolis, Indiana