I have had two different chin implants and it still doesn't look right? My doctor is not wanting to remove the implant to place another one. He states it's not a good idea to keep removing and placing chin implants due to the erosion of my bone. He is suggesting fat injections to correct what i dislike. Basically i want my chin to be continues. Currently that is not the case and it looks like I have a dent on each side of my chin. Is it common practice to do both chin and fat injection?
Unhappy With Chin Implants- Will Fat Transfer Change The Look?
Doctor Answers (6)
Have a consult with a Board Certified Plastic Surgeon and have your chin evaluated for a possible revision. Thank you for your question and good luck with everything.
Post chin implant and fat grafting
Options after Chin Implant
The indentation on either side of your chin is pre-jowl sulcus accentuated by the implant. You can certainly try non-surgical options such as fillers/fat but most of these have to be repeated and because of your age would mean years of treatment. Changing your implant is definitely an option. Usually, I show patients a model of the implant to help them visualize the change. While I don't typically recommend repeated surgery in the same area I think in your situation it will make the best impact and will save costs over time. Surgeons solve problems differently, however, so have a frank conversation with yours for the best options in his/her hands. Good luck!
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Chin implant "dents" in pre-jowl areas.
I think you have had the wrong implants used, not once, but twice. For the continuous line you seek, you should have a Flowers mandibular glove vertical tilt extended anatomic chin implant. What did your surgeon use (both times)? This is critical to giving you proper further advice.
I do not advocate use of injectable Silikon-1000, as it can migrate, become "lumpy," or in some cases cause a granulomatous reaction. Once in it is virtually impossible to remove. I would recommend hydroxyapatite granules or Radiesse as close to the mandible as possible if you want to go the "injectable" route. Since what you want is a smooth mandibular (bony) line, soft tissue fillers (including fat grafts) may give you the "look" but not the normal and natural permanent "feel" the right implant will yield.
Thus, I really think you just need the "right" chin implant to solve your problem. Even a Mittleman prejowl implant might be a better choice than the "button-type" chin implant you probably have. Each of my chin implant patients in the link below have the Flowers extended anatomic chin implant (they come in many different sizes and projections). Good luck!
A well-performed Injectable Filler treatment may be used to fill the indentations on both sides of your chin implant.
I read your concern and reviewed your photo:
You have a nice result after your 2nd chin implant, and you should leave revision surgery as a last resort. You have typical indentations in between your chin and jowls on both sides. I have had good success filling these areas (pre-jowl sulci) with Silikon-1000, an off-label filler for permanent results.
You could have fat injections to these areas, but that would likely involve a higher cost, and more downtime.
I hope this is helpful for you.
Chin implants and fat grafting
If you are trying to avoid removing the chin implant, but want to improve the contour of the chin and jawline to make it appear more smooth, fat grafting is an option. Fat would be placed along the jawline to fill in the depressions on each side of the implant.
Another great option would be to try a filler in these regions. You can use something like Restylane, Juvederm, or Radiesse in the same way that you could use fat injections. This would also give you an idea of whether you like the results before trying the fat grafting which could be permanent.
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