Will Hardware Removal After A Sliding Genioplasty Improve My Chin Tightness?

Q: Dr. Eppley, I’m looking to get my genioplasty plates removed from a procedure two years ago. However this would be my 4th procedure on my chin. For a timeline , 2 years ago I had a genioplasty with a chin implant placed at the same time. After my procedure I had hardware failure so after a month the surgeon went back in and plated everything properly, however after two months the chin implant got infected and had to be removed. Making in total 3 operations on my chin. I’m hoping to get plate removal in the hope to resolve some tightness and what I feel to be inflammation from the plates. I also have a concern as one of my plates goes beyond the lower mandible border. One of my major concerns however is the mentalis muscle, I am worried as I’ve had three operations already that my mentalis must be traumatized , would having to cut through a 4th time pose a risk. However I really would like to have these plates removed. My surgeon has refused saying there is no need, and I hear you are one of the best.

A: By your own description you appear set on having your chin hardware removed so I am not sure in that intent what difference it will make in terms of the mentalis muscle sustaining more surgical trauma.

What I can say that is useful is that I have seen many patients that come to me after a genioplasty done elsewhere who have had tightness and their surgeon removed their hardware to relieve it…and not a single one has developed an improvement in their chin tightness symptoms. This does not surprise me since hardware would not cause tightness…it is merely an easily identified potential cause because it is an implant. The reality is it is a soft tissue deficiency problem that is often not diagnosed whose cause, in your case, is multiple surgeries. You simply can’t cut through the attachment of the mentalis muscle numerous times and expect their to be no soft tissue ramifications from it. Incisions are not zippers, there is no opening and closing them repeatedly without consequences.

While you can have your hardware removed, expecting improvement in your chin tightness symptoms in only going with a concomitant soft tissue management strategy. (dermal-fat grafting)

Dr. Barry Eppley

World-Renowned Plastic Surgeon