Will A Chin Implant Replacement Get Rid Of The Chronic Pain?

Q: Dr. Eppley, Before the scan today, I was up all night last night racked in pain from my chin implant surgery done in 2014. The Medpor chin mplant really aches (a dull pain), almost all day, every day. Sometimes much worse than others. 

My question is: will the silicone chin implant replacement cause the same sort of pain? Is this standard with implants? I just wonder if the new silicone implant is ‘lighter’ than Medpor, and obviously not as big, if the unnatural pressure (and resulting pain/sensation) will be less?

Do you think I am on the right path with this custom chin implant? Hope I’ve expressed my concerns. I just would hate to have to go through this again. I would consider having the whole thing reversed if there are no risks, but am really looking for your best suggestion. Aesthetics at this point are not my top priority – ideally I would like to get back the comfort and ‘natural’ look while at the same time keeping the image as close to now as is possible. I realize of course that there will come a change in appearance with any option I choose. Hope I’ve expressed that intelligibly.

A: Thank you for your detailed commentary and the pictures. If I understand your surgical history properly you had a sliding genioplasty in 2010 followed with a Medpor chin implant in 2014 to which I can make the following comments:

1) Chronic pain after any type of chin surgery, (sliding genioplasty or implant) is not common at all. It is actually relatively rare but I have seen a few cases of it with implants, most of which have been with Medpor implants. I don’t know if it is the material per se but I suspect it may be due to ‘oversizing’ where chronic stretch is placed on the naturally tighter soft issues of the chin.

2) I can provide a more qualified opinion when I see the scan. But in the few chronic pain chin mplant cases I have seen, exchanging it for a smaller implant that fits the bone better has resulted in symptom resolution. This is also the possibility that these larger Medpor implants can have their wings closer to the mental nerve which can also be a source of chronic discomfort.

3) Of course we know how to have an assured pain free outcome (total implant removal) but that may be an aesthetically radical solution until absolutely prove it is necessary.

Dr. Barry Eppley

Indianapolis, Indiana