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Chin implants are secured by placement inside a well-fitted pocket and anchoring it to surrounding tissue so it doesn't move. I also use a permanent stitch to hold it in the midline position for silicone implants and for Medpore implants a scew is used.The incision is then closed, and in 30 to 45 minutes the procedure is done, unless the patient has requested other procedures as well.
When placing a chin implant it must be secured in place so it does not move around. The key to doing this is to place the implant in a secure and tight pocket between the bone and the periosteum and to also suture the implant to the periosteum blanket. Another important factor is to ensure placement in the center of the chin for even contour. Best regards, Dr. Weiss
If the chin implant pocket is precisely made, the implant will not move. Normal scar tissue forms around the implant and I tell my patients that they could be a boxer in as few as 6 weeks. In other words, you would have to be hit in the jaw so hard, that you would break your jaw before you would move the implant. I rarely would screw an implant in place, but there are some Doctors who prefer that technique. Discuss this in detail with your surgeon.
When a chin implant is placed a precise pocket is formed involving both the bone and the layer of tissue just above the bone. Whether the surgeon fixates the implant or not is entirely surgeon preference and not something that the patient really has to worry about. Try not to worry too much about the individual steps of the surgery. Find a surgeon that you like and trust and let them decide how to perform the surgery. Good luck!
Depending on the type of implant and the surgeon's preference, training, and habit, there are different ways of trying to ensure the chin implant doesn't "move around" or become malpositioned during healing. I use extended anatomic Flowers mandibular glove vertical tilt solid silicone elastomer chin implants the most, as these provide a secure anatomic "fit" with the normal bony contours of the anterior mandible. They almost "snap" into place, but the pocket must be carefully created to be the exact size and position you want the implant to end up in. Exact pocket size is the best way to keep an implant immobile, but there are also permanent or dissolving sutures to hold it in place as the scar heals around it and then it's pretty much "stuck in place!" Medpore implants have tiny interstices ("pores") into which tissue grows, immobilizing it. Of course, this needs to be kept in proper position until that tissue in-grows, so exact pocket creation again is important, as well as a temporary (or permanent) fixation suture. Bony chin surgery (sliding genioplasty) involves sawing off the underside of the chin and then advancing it into the desired position and then screwing it into place with titanium plates and screws. This sounds worse than it is, but frankly, though I have had significant craniofacial training and am fully capable of performing this operation, I think it has a proper place in only a minority of patients. The anatomic silicone implants are just that superior, IMHO. They can be easily removed or changed in size also (though this is rarely necessary if your initial choices are good), whereas the bone surgery pretty much is what it is and cannot be easily revised. Also, while the "invisible" intra-oral incision may seem to be a good way to go, this incision choice has a higher risk of infection than the submental incision (just beneath the chin, where many of us already have a scar from that clonk on our parents' coffee table as a toddler). I prefer the external approach because of the lower infection risk, the better visibility of the mental nerves (these should be preserved to avoid numbness of the lips, gum, and chin), and the fact that, properly closed, it heals nearly imperceptibly. This also allow me to remove the fatty pad under the chin that improves the cosmetic result by an additional factor! So as you see, it's less about what is used, but rather how carefully the surgery is performed that keeps the implant where you want it. If it "slides around" after surgery, there is no chin strap or elastic chin holder that will secure the implant as well as better surgical technique! For examples of my patients undergoing this procedure, click on the link below. Best wishes!