Q: Do you use screw fixation for your silicone chin implants? I have a silicone chin implant that moved upward off the inferior part of my chin. I am looking to do a revision but I want some type of screw fixation this time.
A: If a chin implant has slide too far upward for optimal chin projection, it was likely placed through an intraoral (inside the mouth) incision. This is a common problem with this approach as the dissection and the pocket created allows the implant to slide up towards the incision after surgery…unless it is secured in a low position on the chin bone by a screw. This problem does not usually arise when the incisional approach is from a skin incision under the chin as the undisturbed mentalis muscle keeps a firm ‘roof’ over the implant.
In any type of chin implant revision, where the problem is shifting from the ideal position, some method of implant fixation is needed. The easiest and most economical approach is to use a single midline screw to the bone. If side-to-side shifting is the problem (rotation), then double screw fixation may be needed.
While screw fixation of chin implants can be very helpful, it is not always needed in a primary or initial surgery. Many chin implants can be secured in the midline with a simple resorbable suture to the periosteum covering of the bone. But implants placed from inside the mouth or those that need to be kept positioned very low on the bone for optimizing vertical height need screw fixation.
Dr. Barry Eppley