Q: Dr. Eppley, I have a question. I had a chin implant done on Aug 6th and I am experiencing lower lip and chin numbness on the left side. My smile is not the same as it was and I am starting to get concerned. The numbness is my real concern as it is driving me crazy. I don’t know what to do and I am becoming depressed. I am only 22 years old and I do not want this feeling for the rest of my life. Do you think it will go away? Should I get the implant removed or will this cause more injury to the nerve? Please if you could get back to me I would really appreciate it.
A: The recovery from chin implant surgery is almost always more significant than patients realize or have been told. (or what they have heard when the recovery part is discussed with them) It takes a good 6 weeks for about 90% of the recovery to have occurred. Chin stiffness, distortion, numbness and a lower lip or smile that is not normal is all part of the recovery process. Given that you are just one week from surgery, your concerns are way premature and you need to let the process work itself out for 4 to 6 weeks after surgery. Most of your current issues will either be gone or be well on the way to recovery that you will likely be happy than you had the procedure. Your lip numbness would be more concerning if it was still present in its current degree without any improvement at six weeks after surgery
Dr. Barry Eppley
Q: Dr. Eppley, assuming that all goes well when putting in a chin implant, what about the feeling of having it. (mandibular nerves and the touch receptors of the hands?) How physically light is the implant? Will it feel weighted? I’m sure that your own senses will eventually incorporate it into being a part of it, but what about others. Will it be discernible if say someone else touches your face (jaw)? I know this is a tricky question, coming from a post operational/personal standpoint, but thanks for taking the time to answer.
A: The question you are asking it one related to every type of face and body implant…that of incorporating it as part of yourself and no longer have it feeling foreign. And I think the answer is the same for a chin implant as it would be for a breast implant for example. Intially the implant feels different as the tissues are tight and swollen and the overlying skin is numb. It probably takes about 6 weeks after surgery until it begins to feel more natural and really 3 months until it becomes part of you. At this point, the overlying tissues are relaxed and normal feeling has largely returned to the skin. The chin implant can largely not be detected by yourself or anyone else at that point. While for a patient three months seems like a long time, it is actually relatively short and it is amazing how soon one incorporates the new contours of their face into their body image.
The weight of a chin implant is but a few ounces. It is lighter than bone of the same size.
Dr. Barry Eppley
Q: Dr. Eppley, about six months ago I had a medpor chin implant inserted through an intraoral incision and secured with screws. Unfortunately, the wings were too large and malpositioned. I had a revision one month ago in which the implant was removed, trimmed and re-inserted. Now the implant is the right shape and size, but my lower lip feels shorter and tighter. The top halves of my lower teeth show with the lip at rest, and I can barely raise it enough to cover them. When raised, the lip is lower in the center than at the sides. After the original surgery I had the same problem but not as bad, and the lip eventually went back to normal. This time the lip seems worse, and I’m worried it might stay this way. My Dr. said getting the medpor implant out was “very difficult” and it took twice as long as he expected. The implant actually broke when he took it out and he added 2 extra screws to hold it together when he re-inserted it. My chin and lower lip where very swollen for two weeks afterward and the center of the lip is still slightly numb. I’m worried I might have a problem with my mentalis muscle. Does my lip issue sound like something that will go back to normal on its own or like something that will require correction? Thanks for any advice.
A: In your history you have said the key words…intraoral incision. When using this approach for chin augmentation, the superior bone attachments of the mentalis muscle are cut and have to be resutured at the end of the procedure. Besides the numbness,, it is common to have some lower lip tightening and little tethering until the tissues heal and relax again. Going through the muscle twice, particularly in a more extensive revisional procedure, traumatizes and scars the muscle again…making symptoms of tethering and lower lip retraction more significant. It is too early to tell whether this problem is temporary or permanent. If it has not significantly improved by three months after surgery then I would recommend a mentalis muscle v-y lengthening and resuspension procedure.
Dr. Barry Eppley