Q: Dr. Eppley, I had a jaw/chin implant 14 weeks ago, it was two separate pieces that were screwed in. I would assume most of my swelling is gone but I have asymmetry as one side is lower….my Dr. is a reputable surgeon and is working with me, we meet approx every 5 weeks or so….he said if necessary he can go in to the one side, make a small incision and file it down some (not remove it)…he also put some filler in the area right where the implant starts at the jaw so you can see it….said there is permanent filler we can use down the road….I guess my question is how does this sound to you…..is filing down of an implant an option when there is tweeking to do?? I greatly appreciate your help….also is filler routinely used to help “fill in” near and around an implant for a more natural appearance and do you advise that. Thank you for your time!
A: Let me make sure I understand exactly what implant you have. Using the term jaw/chin implant could be either an isolated chin implant or a combination chin and jaw angle implants. I suspect you mean a chin implant because it is two-pieces which would also make it a Medpor two-piece chin implant. If there is asymmetry between the two positions of the two pieces and you are certain that it is not just swelling (more than 3 months after surgery), the best approach is to go in, unscrew the implant, reposition it higher and screw it back into place. There is nothing wrong with cutting down the lower side but that can be harder than it seems to do smoothly and evenly with the implant in place. As a general rule it is always better to fix the primary problem (implant) rather than investing in camouflaging the problem by injectable fillers.
Dr. Barry Eppley