How Should I Replace My Chin Implant Without Using Another Chin Implant?
Q: Dr. Eppley, I have a chin implant which is a medical grade silicone implant by Implantech. Over the last couple years my chin has changed. I think the implant shifted. Recently in the last few months I felt a tearing sensation on the left side, along with pain and itching. Now there’s a little divot along the left side and to me it looks like it shifted up closer to my mouth. I’m concerned that it shifted up or scar tissue tore as well as bone erosion. I want it out my face. I’m concerned about my skin not shrinking back after having it for 20+ years and I’d rather not go back to a recessed chin. My mouth is moving normally and I’m not in pain. It does feel weird compared to the left side. I can almost feel it now being closer to my mouth on that left side.
Can the implant be removed and hydroxyapatite be used to create a chin?
How about a sliding genioplasty without another implant?
A: Normally I would get a 3D CT scan of the lower jaw to fully understand the chin position on the bone and what style/size the chin implant is. But since it is clear that you want it removed and not replaced with another implant then the scan will not be useful. The question then is not whether it needs to be removed but what to replace it with and what should those dimensional changes be.
Hydroxyapatite cement is a theoretical replacement but it is a hard material to control its shape and would only be viable if just a few millimeters of augmentation were needed in the central chin. A more controllable autologous option is a sliding genioplasty. The only question with it is what are the dimensional movements needed. That can be determined by how you feel about current chin look and what contribution the indwelling chin implant is making towards your current chin shape. (which can be accurately determined intraoperatively with its removal) That would then guide the amount of horizontal chin bone advancement.
Dr. Barry Eppley