Medpor Chin Implant Removal
Q: Dr. Eppley, i had a few quick questions about Medpor chin implant removal in advance so that I can speak with you with a clearer understanding of surgical possibilities next week.
1) If an implant is placed via an intra-oral incision, can it still be accessed via a sub-mental one?
2) Instead of removing a Medpor implant and replacing it with a different shape or size, can it be edited / cut down whilst still attached to the chin?
3) In my case my lip function is perfect. However the position of the lip is not correct; it feels like my lip is being pulled downwards by the weight of my mentalis muscle which (i believe) was not reattached successfully. Can the reattachment be made without further risk to the muscle-lip function?
Of course our conference call should give you a better visual idea of my situation and whether or not i have correctly identified the problems i am noticing.
I look forward to your thoughts.
A: In answer to your Medpor chin implant removal questions:
1) A chin implant that was placed intraorally can be subsequently accessed from a submental incision.
2) It is almost never a good idea to modify a chin implant in place as the amount and type of modification is very restrictive…and thus limits what can be effectively done.
3) I doubt very highly that the mentalis muscle was not reattached properly as there is only one way to do it…it is either done or it isn’t. It is important to remember that a chin implant displaces the muscle in an unnatural way forward. Your anatomy was not made to have an implant behind it. When this natural anatomy is changed and the muscle is dragged up over an implant, particularly one that gets a lot of soft tissue adherence, the risk is that it may feel stuck or being pulled down. That is why it feels the way it does, it has nothing to do with the muscle per se and messing with the muscle is going to create more problems not less.
Dr. Barry Eppley