My recently placed chin implant (7 days) is misaligned. Surgeon believes it is centered. I do not. How do I proceed from here?

It is way too early to pass judgement on your procedure. Remember that most chin and cheek implants are not custom designed. If you had a preexisting asymmetry in the size or shape of your chin, then you will still have some asymmetry afterwards. Since post-operative swelling is not typically uniform,  I suggest that you allow at least 6-8 weeks before you scrutinize the result.  Before and after photographs are often the best way to visualize the impact of the procedure on facial balance and harmony, and can also be used to point out any preexisting asymmetries. Discuss your concerns with your physician at the appropriate time. Best wishes.

Early healing after a chin implant can entail swelling and bruising around the implant and in the pocket. This can throw the result off under early scrutiny. Allowing the swelling and possible bruising to go down over the first 3 weeks is important. Taping and massage could be started after one week. Any implant can accentuate pre-existing asymmetry not picked up pre-operatively. I usually do cortical tunnels in the bone to help secure the implant to help prevent any shift. Early revision would not be entertained for at least a month. 

The face of most patients is asymmetric. The centerline of the face is defined by the outward appearance of the soft tissue of the nose, mouth and chin. These landmarks, however, often do no coincide and are often further malaligned with the skeletal midline of the mouth as defined by the central incisors of the maxilla and the mandible. One’s impression of the center of the face is formed by how one reconciles these various landmarks and by what landmark one gives the most importance. The subjective nature of defining the midline and the interplay of the chin with the the rest of the face makes chin augmentation more challenging then just inserting an implant. Chin augmentation requires a detailed analysis of the face and a discussion of patients concerns and expectations in order to formulate a successful surgical plan. Post operatively, assuming there is no infection, nerve entrapment, or gross malposition of the implant, patients should allow 1-2 months for the swelling to resolve before contemplating any changes. At that point, a detailed follow-up exam and discussion will help delineate the best treatment option.