This will be implant #3. Actually my doctor just wants to add fat to my dents on the side. Its been 11 months months since I've had my last chin implant and I'm still a bit numb and uncomfortable. Will I get better? Will this numbness go away. Is fat injections a good idea?
Do I Need a Smaller, Different Chin Implant or is Fat Injections Ok?
Doctor Answers (3)
Fat Transfer or Fat Graft good option for failed Chin Implant
More and more Fat Transfer or Fat Grafting has proven to be an excellent technique for correcting contour problems associated with Implants, including Chin Implant and Breast Implants.
In your situation with "dents" or contour deformity following a 3rd Chin Implant, Fat Transfer or Fat Graft by per cutaneous Fat Injection is an excellent procedure. Fat can be injected specifically into the depressed areas to create a smooth appearance.
It is crucial that Fat Harvest for transfer is done using newer Fat Harvesting techniques to assure the survival of the Fat Cells that are transferred.
In the past, many excellent Fat Transfer or Fat Graft results have failed because the Fat Cells died after injection. Rates of cell death as high as 60% have been recorded.
Newer techniques of Fat Harvest for Fat Transfer or Fat Grafting allow for up to 90% survival of the Fat Cells which will improve the longevity of results.
We use a Fat Harvesting Method called the Adivive System which produces a high concentration of living cells and removes damaged cells
A fat transfer is not a bad idea provided there is enough time for the swelling to subside and an accurate assessment can be performed. Wait for about 6-8 months, then reassess.
Chin implants vs fat transfer
For the reasons you have described I think chin implants are a good idea only for the elderly who cannot tolerate any more then the most minimal procedure. Outside of that situation I NEVER use chin implants because:
They have a never ending chance of migrating
Can temporarily or PERMANENTLY cause numbness and pain
They have a lifelong risk of infection
They ALWAYS erode both the bone underneath and soft tissue above causing progressive deformity that is difficult to fix
The aesthetic goals that can be achieved are extremely limited and one dimensional
Well I could go on but I think that is sufficient to explain why they are a bad choice in general. I usually address augmenting the chin by designing a three dimensional genioplasty to fit the patients face. All factors- hieght width projection and symmetry can be addressed in this way delivering a permanent result with no foreign bodies. Fat grafting can certainly help but will not give the control and options of a genioplasty.
It is very telling that there are few surgeons competent in genioplasty and osteotomy techniques that use implants even though implants are more profitable. I would recommend doing away with the chin implants and using fat or a genioplasty technique if you are indeed an appropriate candidate. I hope this helps
Rian A. Maercks M.D.
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