Q: Dr. Eppley, I'd like to know based on your experience, how big of a chin implant would you consider as big enough to cause substantial amount of bone erosion From what I understand, chin implant of any size is bound to have some bone erosion to an extent whether or not it's substantially significant or just insignicant at all. Correct me if I'm wrong. When we talk about bone erosion, are we saying a 3-4mm bone erosion years after the surgery depending on the size of the implant? A surgeon suggested 1cm silastic chin implant and she said it's not considered big at all. I thought 1 cm is quite big isnt it so?
A: The issue of bone setting, not erosion, likely occurs with every chin implant to some degree. It is safe although speculative to say that the larger the implant the more settling into the bone that occurs. It is possible that implants of 1cm or more may have up to several millimeters of bone settling. While this is a frequently talked about phenomenon, I think it is clinically irrelevant. It has little impact on the aesthetics of the implant look and no other negative medical issues. It is only relevant if the implant is placed too high on the chin over thinner alveolar bone where implant settling into the bone may have adverse effects on the anterior incisor teeth. But a chin implant has no business being that high up on the bone anyway. It is also less of an issue today in anatomic or more extended implants where the pressure imposed by the implant on the bone is spread over a much larger area. In short, I would not concern yourself with this issue as I have never seen it to pose a problem when the chin implant is in good position over the lower basal bone.
Dr. Barry Eppley