Chin Implant Complications

I have performed many Chin Augmentations with Chin Implants for over 25 years and when performed properly and the correct aesthetic implant is selected, there are very few things that can go wrong.  The main issues to consider when having a Chin Implant surgery are:

1. The aesthetic size, shape and thickness (called projection) of the chin implant.  There is an aesthetic rule, within my Palmer Code beauty principles that defines the proper aesthetic balance of the chin in a man and a woman's face that I have used for over 25 years to make this determination.
2. The approach used to place the Chin Implant.  There are two ways to place a chin implant but I have always only used the external approach through a small curved incision under the chin.  When chin implants are placed through the mouth the attachment of the chin muscle must be cut in order to make the proper space for implant placement.  This causes the chin muscle to sag later in life (ptosis) and may also allow the implant to shift into the groove inside of the mouth.  I have dealt with both scenarios for chin implants placed elsewhere on numerous occasions, so this can and does happen.  When placed through the external approach, the muscle is lifted up but the attachment remains intact. 
3. The level of the chin implant placement.  It is advised that the implant be placed under the periosteum not within the superficial tissues.  This will secure the implant against moving.  Screws are not required to secure chin implants.
4. Typically, chin implant surgery can be done in less than 30 minutes.  There's minimal bruising and swelling.  There may be some mild restriction of movement/temporary numbness of the lower lip based on the added volume (from the implant) under the chin muscle.  This tends to decrease slowly over a few weeks.
5. If an inexperienced surgeon performs the chin implant surgery, there's an increased risk of damaging the marginal mandibular nerve that can lead to permanent loss of lower lip movement.  Like all treatments and procedures the number one goal is to find a plastic and cosmetic surgeon with the proper aesthetics of facial beauty...the second goal is to fine one with a vast experience.
6. Remember, you can always use a filler (I prefer Radiesse) as a non-surgical method of Chin Augmentation if you're not ready for a Chin Implant.  Over half of our chin and cheek implant consults are not candidates for implants and get fillers instead, so this is a real, viable option.

Web reference: http://www.beverlyhills-plasticsurgery.com/chin-implant-surgery/

The complications from a chin implant will vary depending on the type of implant used. Various substances are currently used for chin implants including solid silicone, ePTFE (tradename Goretex), linear high-density polyethylene (tradename Medpor), the patient's own fat, and others.

During the implant procedure, there will be some bleeding and bleeding is possible for several days after surgery. Generally, this bleeding is not life threatening and does not come near requiring blood transfusions.

There is a nerve which provides sensation for the lower lip, lower face, and chin area which comes out of the lower jaw bone on either side just off the midline. This nerve can be bruised and stretched during surgery and, rarely, permanently damaged. This can create a temporary or possibly permanent numbness of the lower lip, lower face, and chin area. This does not in any way affect the movement of the lip but can cause some problems with drinking liquids due to lip numbness, much the same experience as after having injections at the dentist.

Infection is always a risk. If an implant is placed other than fat, infection may require implant removal. Often this can be avoided with prompt antibiotic treatment.

There is always a possibility of implant movement. This usually can be handled with conservative measures, though removal of the implant is possible.

Any implants will show some resorption of the bottom jaw bone over time. This is usually not a problem and can only be seen on x-ray. In people with very thin jaw bones this resorption can lead to breakage of the bone which would require repair but this is a rare complication.

As with any surgical procedure, other risks may pertain to your specific situation given other medical conditions. It is imperative to speak with a knowledgeable surgeon before undertaking any surgical procedures and disclose all of your medical conditions.

Possible complications that patients need to be aware of before surgery include:

• Infection
• Bleeding
• Nerve damage
• Mandible bony absorption (a small layer of bone fades away)
• Rejection of the implant
• Lip dysfunction
• Movement of the implant

Web reference: http://www.spaldingplasticsurgery.com/face/

As with any plastic surgery procedure, there are risks of infection and bleeding associated with having a chin implant. Fortunately, both of these are quite rare, especially if the implant is placed from under the chin where a sterile environment can be maintained during placement of the implant (as opposed to going through the mouth to place the implant).

In addition, there are risks of possible nerve and muscle damage from the chin implant. There are both sensory (sensation) nerves and motor (movement) nerves around the jaw that can be inadvertently injured during the procedure. Sometimes the muscle can also be affected from the implant, causing abnormal movement of the lower lip with a change in pattern of speech.

There is also a chance that the implant can cause absorption of the underlying jaw bone, which takes away from the desired effect of providing an augmented appearance. Finally, you may simply not like the appearance of your lower face following the chin implant procedure. Fortunately, a majority of patients undergoing this type of procedure end up fairly happy with their results with minimal complications.

Web reference: http://www.drhilinski.com/procedures/facial-implants-san-diego-ca/

All complication of chin augmentation are covered in details by my colleagues. One statement that I may disagree is which incision (inside the mouth or bellow the chin) is safer. It doesn't  make  difference regarding placement of implant, accuracy of correction or incidence of implant infection whether intraoral or external incision is used. I usually let patient make that decision. Good oral hygiene after surgery and soft diet will eliminate problem with intraoral incision. I use silicone implants all the time due to wider range of shapes and sizes and ease of replacement if needed.  

 In our practice we insert chin implants under local anesthesia. We also give patients antibiotics to prevent an infection. We have seen a handful of patients where the tail of the implant has become displaced( Folded  over) and must  undergo a touch-up to put the implant tail in the proper position.We have seen a few patients who have ended up with a small area of numbness on the upper lip after the procedure in the last 25 years

Web reference: http://www.chincheekimplantsseattle.com

Experience, experience, experience.

 

Anyone can have complications from chin implant surgery or chin augmentation surgery. Augmentation with implants are as follows:

1.  Numbness of the lower lip either on one side or both sides. In the literature it stated that this happens anywhere from 3% to 10% of the time. However, in most experienced surgeons practices long-term numbness should be less than 3%. When it does occur is most often temporary and can last weeks to months. The approach you take for surgery, external incision versus intraoral incision, can affect this. The risks are higher with the intraoral approach.

2.  Infection from implant placement is very rare especially when using an external incision just under the chin. If an infection results it can show itself within a week to even several weeks. It typically comes in the form of increasing pain not decreasing pain, redness, warmth, or new onset of lower lip numbness when there was none before.

3. Under correction or overcorrection. This is simply dealt with by replacing the implant or augmenting under correction with some filler or fat transfer.

4. Visible incision under the chin. I operate on Asian, African-American, and Mediterranean patients all the time and I most frequently use incision underneath the chin because I like its low complication profile. It is possible that the incision, he will and require some revision several weeks from now but I've never had to do it. I have revised incisions from overseas and most of those cases were instances where external sutures were left just too long. There are special techniques for closure that makes this possibility very remote.

 

best of luck

 

Chase Lay, MD

Web reference: http://chaselaymd.com/Chin_Implant.php

Chin augmentations with implants are subject to the usual surgical potential dangers: infection, hematoma, seroma, and malpositioning.  Then there are specific dangers such as erosion of the mandible, assymetric prolapse of one side of the implant below the mandible which can be both visible and palpable.  Sensory loss to the lip and/or sensory or motor damage to the muscles that surround the lip are also possible.

The most common complication is malpositioning and this can be eliminated by placing titanium screws through the implant into the mandible.  This stabilization also decreases post operative swelling and speeds recovery.  I place all my implants in through the mouth; this leaves no visible scar and I've done several hundred without any sign of infection. 

My collegues have listed just about every possible complication that I can think of with chin implants, but remember that a silicone chin implant can usually be easily removed if it is not the look that you want as a minor office procedure. Some of the other materials, including your own fat, not so easy to remodel or remove.

Complications can depend on the type of material used, but I will concentrate on the standard Goretex and silastic implants and name a few:

Possible complications:

extrusion - implant making its way out

infection - usually requires removal

mobility - too mobile due to the receiving pocket being made too large

nerve / sensation problems - implant can possible impinge on the mental nerve

aesthetic - patient doesn't like the fundamental appearance change afforded by the implant

bony resorption - resorption of bone under the central aspect of the implant