I had a chin implant inserted intra-orally. If I were to undergo a revision, could an extra-oral approach be used? Or would the 'pocket' become a 'pipe' where there is no bottom/top 'holding' the implant? Or is it a different pocket altogether?
Chin Implant Intra-oral Approach, but Revision Extra-oral Approach? Possible?
Doctor Answers 5
Extra-oral Approach for Chin Revision
You can have an external incision to revise your chin implant; this is the approach I prefer whether I'm doing a primary or revision procedure.
Submental Approach for Chin Implant Revision
There is no problem in revising a chin implant by changing the incision to the external submental approach. This is true regardless of whether it is an implant repositioning or replacement with a new chin implant. The pockets would be connected presuming the initial intraoral approach placed the implant in a subperiosteal position. Given that the two pockets would be connected (one larger pocket), I would advise that the implant be secured into position with a screw to prevent upward displacement which is possible given that the old pocket will still be there until more complete healing occurs.
Exchange of Chin Implant Through Different Route
Scar forms around any implant after a few weeks that is strong enough to prevent superior migration even if the submental approach is chosen. Also the pocket above should have been closed with suture to resuspend the muscle and close the mucosa. Similarly, when the new implant is placed, sutures will prevent inferior migration as well.
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Revise chin implant
I would see no problem using my preferred extra oral approach to chin implants even with a prior intramural ly inserted implant.
Revision Chin implant
Thank you for the inquiry.
Performing a revisionsurgery can be done either way but I do prefer the extra-oral approach.the reason for this is I feel that there is less complications with the extra-oral route with less infection, less now position, and not to mention that the tissues in your oral cavity have been thinned by the previous surgery. You can have a somewhat large pocket if you're current implant is sitting too high on the mandible otherwise I don't see that it would be an issue so long as you make the pocket the right size and you fixate the inferior edge of the implant to the covering of the bone called the periosteum with the suture. I would just do this under local and you should do well.
Hope that was helpful
Chase Lay, MD