How Do You Fix A Malpositioned Chin Implant?

Q: Dear Dr. Eppley, I read your article where you speak about chin implants and you say: “Lateral or wing malpositioning is actually the most common problem and is a result of the newer styles having thin and more floppy wing extensions which can easily fold onto themselves” . I would be most grateful if you could advise on the best way to correct misplaced wings on the side of the jaw.

A: Unlike chin implants of old, most contemporary chin implant styles are more anatomic in design and shape. This means that rather than having a simplistic button or oval shape that just sits on the very end of the chin bone, they are longer and wrap around the bone to flow more confluently into the body of the mandible. This gives them long wings or lateral extensions along their sides. With silicone chin implants, these wings have thinner material thicknesses that end in minute paper-thin extensions. Because silicone is flexible, this makes them prone to fold upon themselves or buckle if the implant pocket is not dissected far enough back. Also they can ride upward or downward based on the angulation of the pocket dissection. Either way, these implant wing malpositions will be felt or seen as a lump or bump along the jawline. With Medpor chin implants, these wing malformations do not occur as the material is much stiffer and not flexible so the ends do not bend.

With chin implant wing malformations, the only way to correct them is to do an open revision. The implant is removed, the pocket checked and dissected further if needed and the implant then re-inserted. In some cases, the fine ends of the wings are removed as they serve no volume or contour purposes.

Dr. Barry Eppley

Indianapolis, Indiana