Q: Dr. Eppley, I am writing about my chin implant that I had placed three years ago at the time of my facelift. I did not even want a chin implant in the first place but my surgeon talked me into a small one. After this, there was a huge downward bulge on the right side (wing area). It was a flowers small implant inserted through the chin. When I went back to complained, he told me I was imagining it. I was so intimidated, I left it in even though it was impossible to miss it and I could not believe he denied it. Shortly thereafter, I got the courage to re-approach him. He conceded that maybe he could fix it a little this time and it was an incredibly painful experience, the numbing injections were horrible. He told me he was repositioning it but there was risk of nerve damage and that if I removed it completely (my first request) there was even more risk of nerve damage, so I was too scared to take it out completely. Well, he fixed it…but it is still bothering me – it hurts on that side – aches, pains and also I can easily still feel the bulge of the uneven placement even after that “fix”. I cannot lie down with that side of my face or it hurts quite a lot after a while. I am afraid it is an infection that flares up from time to time. Also, many of my teeth are showing cavities or rotting and I am wondering could this be bone erosion of some sort? I would like the chin implant removed, if possible – I am concerned about skin sagging, so I guess I would like the sub-mental tuck done too if you recommend that. Do you think I have a high risk of skin sagging?
A: The simple solution is to just have the chin implant removed. This is an easy procedure since it is a smooth silicone implant and has no risk of nerve damage or exacerbating one even if it already exists. Given that this is a small implant I doubt that there will be any risk of significant soft tissue chin ptosis. I would remove it through the original submental incision and do a slight tuckup of the chin soft tissues at the same time. Your chin implant is not the source of your teeth condition and there is no correlation whatsoever between it and your dental or medical health.
Dr. Barry Eppley