Q: Dr. Eppley, I had a sliding genioplasty four years ago. Everything went well and I like the result. My surgeon told me that he could remove the titanium plates and the screws but it wouldn’t be a problem if they stay inside me for the rest of my life. So I decided to let them stay inside of my chin. Last week I meet another surgeon who said that titanium plates and screws should be removed in younger patients. On ‘House MD’ it has been shown that titanium plates can severely burn soft tissue and skin when an MRI is needed. Is this true? Should my titanium plates be removed because they can lead to bone resorption or other problems in the future?
A: The simple answer to your question is that none of what you have heard or been told is true. Titanium is the most biocompatible metal in the body which is why it is so commonly used. In facial plates and screws it is a nearly pure metal to which bone will bond directly (and often grow over) and it is non-ferromagnetic so it is not affected by the powerful magnetic influence of an MRI. There is no reason whatsoever, therefore, to remove your chin osteotomy plates and screws. Of all the places on the face where rigid fixation is used, the chin is the one area where I have never seen any long-problems such as loosening, irritation, or interference with function. Removing them may be a good exercise for the surgeon but is of no benefit to you at all.
Dr. Barry Eppley