What Can Be Done For Scar Adhesions After Multiple Intraoral Chin Implant Surgeries?

Q: Dr. Eppley, I have a 9mm medpor chin implant placed last year from a submental approach which was not secured by the screws. One month after 1 surgery it shifted. Then two small titanium screws from an intraoral approach were placed but it shifted again. Thereafter two larger titanium screws were inserted also from an intraoral approach. Unfortunately, I was eager to have two more large screws after some trauma placed because I feared malposition which was also done.

Thereafter, I developed scar adhesion after triple surgeries in a 6 month period from the intraoral approaches!!! This creates bumps over the implant, and causes me intermittent numbness and lack of mentalis control. 

I’m extremely frustrated… I guess it’s pretty hard to remedy. I know you are an expert on chin implants. I was wondering if it’s possible to deal with this situation? Many thanks.

A: As you have aptly stated stated you have developed scar tissue from multiple intraoral entrances through the same incision. Like scar adhesions anywhere on the body they are treated by release and the placement of an interpositional soft tissue graft of which my preference is a autologous dermal fat graft. This will certainly remedy the scar adhesions, where that also improves mentalis muscle function fully can not be predicted beforehand but the two are almost always related to a significant degree.

Dr. Barry Eppley

Indianapolis, Indiana