Q : Hello Doctor, I had a chin implant in November 2008. It got infected and had to be removed two weeks later. Now after one and a half years later my chin is still loose and stretched, making my chin look like it is hanging and looks weirdly different. I like to find out if there is a way of fixing this by shrinking and tightening my chin that will hold my face together the way it was before. Thank you for your time and help, hope to hear from you very soon.
A: In placing a chin implant, it is necessary to lift the mentalis muscle off of the bone. Like placing a breast implant, this stretchs the overlying tissues out. As a result, if chin implants are ever removed there is a risk of the tissues not shrinking back down and become ptotic. (sagging off the bone) This is a well recognized chin problem whose occurrence is more likely the larger the chin implant that was used. The risk of chin sagging is also greater if the pathway in which the chin implant was originally placed and removed was done from inside the mouth. (this method separates a greater amount of mentalis muscle)
Chin ptosis, also known as a ‘witch’s chin’ deformity, can be corrected through two different methods. If you want to get the effect of greater chin prominence that you were originally after, replacement of a new chin implant or moving the chin bone forward (chin osteotomy) can be done. This will give more chin projection and pick up the sagging chin tissues. If you are not interested in any further chin projection, then the mentalis muscle must be shortened and tightened to readapt the soft tissues back on the chin bone. This can be done either from inside the mouth using resorbable bone anchors or from an incision on the underside of the chin. (submental tuckup)
Dr. Barry Eppley