My implant is silastic and the largest available#4. It increased the chin projection by 9mm. A cuff of periosteum was left between bone and implant near the midline to minimize bone resorption. Was this a good solution to avoid bone resoprtion ? Will I have to do another replacement in future ?
Silastic Chin Implant - Long-Term Expectations?
Doctor Answers (6)
Leaving periosteum down is the "right answer"
As you imply, leaving periosteum down, at least centrally under a large chin implant, is thought to prevent bone resorption.
In most cases, *if* bone resorption occurs, it is generally only visible on X-ray, and not relevant in day-to-day life.
In my opinion, a second measure to prevent bony resorption is a microscrew to tack the implant in place and prevent micromotion.
Chin Implants Can Cause Bone Resorption
Unfortunately regardless of the method used, chin implants can cause bone resorption. Fortunately, this resorption is rarely clinically significant - meaning that it happens but doesn't need to be treated.
Silastic chin implant expectations--bone resorption over time?
It sounds as if your surgeon has done all that can be done to not only give you a good result now, but also to minimize subsequent bone absorption over time. Good for him/her, and even better for you for selecting such a thoughtful and precise surgeon!
You can still expect a very small degree of bony remodeling around and beneath your chin implant, partly because of the pressure from the (tighter) overlying tissues, those these relax over several weeks to months as your implant surgical site heals and matures. This bony change is generally quite small and occurs over many years. Will more surgery be necessary in the future? No one, including me or your surgeon, can honestly say yes or no, but most will agree it is quite unlikely.
So enjoy your new look and forget worrying about it! Best wishes!
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I tell my patients all implants anywhere will need revisional surgery in the future. Many changes , like aging, resorption, displacement, capsular contracture do occur. All these will need revision.
Bone resorption and chin implantation
Leaving a cuff of periosteum is a good way to try to prevent bone resorption from the chin implant. Even if resorption occurs, it is typically not clinically signficant (i.e., noticeable only on x-ray) and doesn't affect your result.
You don't necessarily have to have the implant replaced in the future.