Chin Implant - Finally - Manassas, VA

I'm excited but nervous as we all are before any...

I'm excited but nervous as we all are before any procedure. I first visited a Cosmetic Surgeon about a chin implant back when I was in my 20's. I seriously considered it at that time, but then the kids came along and my chin didn't seem to be that important. Three years ago, and six kids later, now on the back side of my 40's I again had time to focus on myself and those nagging side view pics that I've always hated. What was different this time is that injectable fillers had entered the market. The first time I tried Radiesse for chin augmentation I was thrilled with the results, unfortunately they didn't last long enough and I was having to re-up the filler about once every 8 months at about $800 per visit. I finally decided last summer that it was the last time I was throwing my money away on dissolvable fillers, so as I started approaching the 7 month mark from the last Radiesse injection I scheduled a consultation with the Board Certified Plastic Surgeon I have been seeing for injections the last few years. Since I'm a little older now and have the beginnings of pre-jowl sulcus volume loss, we decided to go with an extended anatomical size 2 implant. He will also do some very conservative liposuction. The decision to go conservative on the liposuction is based on the fact that I want and need to loose a few pounds (although my neck has always been a little fatty even at a much lower weight) and we are trying to bridge that fine line between getting an improved jaw line and getting saggy skin that needs a neck lift right away now that I'm 49 years old. My long range plan assuming everything goes well with the chin implant is to continue on my diet and exercise routine to get to my ideal weight and then in about 5 years plan for a complete face/neck lift at which time we will address any additional liposuction that may be needed. March 7, 2014 is the planned date and I'll be sure to update afterwards.

It's Chinplant Eve!

I can't believe by this time tomorrow I'll have a new chin. I'm excited and nervous all in one, what if I hate it? What if I'm swollen and bruised so bad I can't leave my house for weeks? What if the "frozen mix" in the weather forecast in the morning prohibits me from getting there on time? Stopped by Walmart tonight and got groceries, lots of soft stuff incase it hurts too much to eat real food, Atkins shakes, sugar free pudding, yogurt and 3 scarves incase I need something to hide behind. I got all my prescriptions filled, Valium for the actual procedure, hydrocodone for pain relief afterwards, 3 Cipro to ward off infection, and a nausea medicine incase any of the other prescriptions make me sick to my stomach. I doubt they will as I've never had that problem before, but got it filled anyhow figuring the one time my face is swollen and hurting will be the one time my stomach decides to act up from the meds. I'll just be glad to have it over and be on the mend by tomorrow afternoon, I'll be back.

Well it's done

Just got home. Haven't seen anything yet he had me wrapped so big and tight all around my head before I got to
a mirror. What I do know is that this hurts much more than I imagined it would, 3 pain pills down and I still don't have the pain under control since the lidocaine has started wearing off, I think it's the liposuction areas that are causing most of the pain rather than the chin implant. I'll share some more later right now I'm hoping to get the edge off the pain enough that I can take a peaceful nap.

Update 15 hours post

It's 3 am and I can't sleep so thought I'd write a little more. While I'm still quite sore I seem to have gotten the pain manageable but it requires 1 oxycodone every 4 hours faithfully. I'm going to try and space them out a little more after 24 hours. So as for the actual surgery it wasn't too bad but honestly in hindsight I think I wood have preferred twilight sedation to just a Valium. I saw, heard, felt and smelled more than I would have liked to especially when he used the cautery tool that smell is sickening. The plan changed slightly from the original in that after trying in the sizers he decided to go with a size 1 extended anatomical implant versus the size 2 we had thought would be the best fit. I'm pleased with that decision after reading a lot of things that said it's better to err on the small side with a female to avoid masculanizing the face.

Normally my doctor would have seen me tomorrow but he is in an alternative office in a location my driver wasn't willing to take me due to construction in the area which makes GPS unreliable. So he said I can wait until Tuesday when he's back in the office we went to today. This means that I will be removing the massive headwrap myself tomorrow, which I'm both excited and terrified to do since it will be my first look at his handy work. As of right now I can already see massive bruising on my neck extending below the headwrap, I'm sure it's not going to be a pretty sight, One good thing I've noticed is despite how often others write about lip numbness I have 100% feeling in my lip from the moment the lidocaine wore off, probably another positive effect of keeping the implant smaller.

I'll try to get some pictures up later today.

Before pic

Oh boy

Just removed my head wrap and can see my lower face and neck better. It's not as bruised as I thought it would be but while my lip has no numbness my lower left lip droops down when I smile. Someone please tell method will go away soon.

Post surgery

24 Hours post op 1

24 hours post op 2

24 hours post op 3

24 hours post op 4

Day 2 update

Today was good as far as the pain went it magically stopped hurting after I took the pain pill at 3 am and has hurt no more, I haven't taken so much as a Tylenol since I got up today. Today was the unavailing do to speak, with disappointment I'm less than impressed and pray things are going to change for the better. I see no improvement in my chin or jawline and what looks like a paralyzed mouth to boot. Although I have no lip numbness my neck is completely numb. I'm trying to reserve judgment until I get some more healing.

Day 3

Today is day 3 and I think I might be seeing a little improvement but it might just be I decided to take a shower and do my hair so I feel better all over. Left lip still won't pull down but still no pain today.

Front view pics

A reader asked to see a front view before so I'm posting a couple that are all after I started using Radiesse. While the fillers came out slightly different each time it shows I didn't have dents before and it didn't look so short and wide, although I was told with the implant I wouldn't need fillers in that area any longer.

Thought for today~

I've never seen a before and after chin implant picture that wasn't an improvement from the starting point (or maybe those that look hideous and the doctors that do them don't post those pics online- that's my evil side speaking, lol). Swelling is coming down but I still feel much broader and squarer in the jaw and chin than I wanted to be. And the dents have me quite concerned, as well as my lip paralysis, I'm afraid something has malpositioned. My right side is definitely worse than my left as far as the dent goes, but then its my left lift that won't pull down, what a mess, thank God I've got a few more days before I have to go back to work. I know I shouldn't, but I'm having a spicy Bloody Mary with a salted rim tonight, I do NOT like pain meds, valium or anything like that but feel I need something to relax with for a bit, I promise to double my water to offset the salt and to take my Arnica and Bromeline to offset the alcohol, plus the arnica cream I've started using on my neck today.

I ventured out of the house for the first time today to the local convenience store as the kids ran out of milk and bread. All my preplanning, with zip up jackets and scarves were futile being our weather has gone from the 20's to the 50's almost overnight and my 11 year old daughter agreed I looked quite ridiculous all bundled up in today's weather, considering I normally don't wear anything more than an open jean jacket in below freezing temps. I just decided to go for it and get in and out as quickly as I could, picking the cashier I thought least likely to make a commotion over the way I looked. I chose the line of a heavy set young woman I chit chat with occasionally, totally prepared if she asked what happened to me to just say "shh, I had a little lipo under the chin". I wasn't gonna mention the chin implant, I figured someone that has struggled with weight issues would better understand why I do these things to myself than the skinny blonde cashier at the next register and most people understand what lipo is more so than a chin implant (fyi: I live in a small rural town where everyone knows everyone so you can't just go somewhere and not be recognized). I share this only because it demonstrates what these things do to you mentally as well as physically. By the way she didn't ask me a thing, doesn't mean she won't ask my adult sons next time they are in what happened to their momma, lol. Since I'm now 18 months a widow, I won't be surprised if the roomer around town is that I've hooked up with some guy that is beating the crap out of me.

Nothing more to say for now, but I appreciate real self and its members for being here as I have no one else to talk to through this journey, the only people who know are my young daughters (5 & 11) who don't even want to look at me right now, my mom, who is half deaf and hard to carry on a conversation with, and 3 of my 4 adult sons who just avoid me until I'm all healed not understanding what is going through my head to put myself through these things, and not a one of them even bothered to call since I had it done to see how I was doing. Yeap, the post surgery depression is sitting in, I've looked forward to this for over 20 years and so far it is NOT what I had hoped for.

Day 5 & First Follow up appointment with my PS

I had my first follow up appointment with my PS today since the surgery. He seemed genuinely empathetic to what I was experiencing with my lip, knowing that we both knew it was a risk but doesn't seem like such a small risk when you are one of the few who experience it. He felt my chin implant all the way up the wings and reassured me that nothing has malspositioned and that the swelling and dent are just part of the process of the trauma. He believes it was the lipo cannula that hit the depressor nerve while working on that pre-jowl area, causing the problem with my lip and feels quite confident that all function will return in 6-8 weeks. In the meantime we decided to go with a small couple of droplets on the opposite side of Dysport just to weaken it a little bit so that I don't have that strange stroke patient look when I talk and smile until the other side wakes up and decides to behave. It means I won't be able to show my bottom teeth at all for a little while, but I'd much prefer that to the lopsided ill look I have now. He injected the tiny amount today and will re-evaluate it on Saturday when I go back to get my stitches removed. With my luck the stunned side will decide to wake up tomorrow and I'll be stuck with the Dysport for awhile, lol, but really the small amount he used, if that were to happen I'm quite confident I could still operate the muscle with a little bit of effort, so it still won't be as bad as it is now, and it won't be perfect but should be better and help get me through the next few weeks.

As for the healing overall, it is coming along nicely, the one side that had the smaller dent near the chin implant had completely released its sunken hold when I woke up yesterday and I have confidence the other side will do the same soon. The lesser bruises have turned to that sickly yellow stage, so even though I know its not great for the skin I got a couple of hours of sunshine during our 75 degree day today as the sun rays are said to help break down that yellow pigmentation, I haven't seen a change yet but maybe it will help it pass. The darker bruises are still pretty dark, but I managed to go out for a bit today regardless. The swelling and the squareness are resolving and improving daily and I'm now quite convinced I'm going to be thrilled with the final results, although I'm sure I still have some ups and downs ahead of me and with the lip issue its turning out to be quite a bit more recovery time than I had anticipated, but I'm hoping to eventually be able to change my review to Worth It!

Day 9 update

Well today is day 9, got my stitches out yesterday, bruising is about gone, but I still have some tenderness on my right jaw line, the lump where I can feel the implant and the paralyzed lip depressor on the same side. The botox only slight straightened out my smile and its really hard to talk like this, but I don't want to put any more botox in and risk the other side coming back and having to wait 3 months for the botox to wear off. Back to work tomorrow, but I will be working at home until Thursday and I'm still praying for a sudden healing from the paralysis before then . Since I have a rather small mouth that doesn't open really wide anyhow I would only need a little bit of function in that depressor to make it work for me. I've also found a hard lump in my neck that I couldn't feel when things were more swollen but you can't see it, I just feel it and understand its part of the process as well. I think overall things are looking pretty good and I'm just being put through a test of patience which is something I admit I entirely lack.

Removing identifying pics

I found that after having to explain my lower lip problem to several friends/coworkers that a couple of people googled my issue and ended up at my post here. Since this was intended to assist those on this journey and not be entertainment for those that maybe don't agree with facial enhancement procedures, I'm deleting my identifying pics. However if you are a contributing member with previous posts and would like to see my progress, shoot me a PM and I'd be happy to share privately.

Day 16

Day 16...... Most of the residual swelling seems to be abating, however my neck is becoming a little lumpy, as to be expected, but not too bad. What's important to point out is that my doctor does not believe in the use of compression garments, if I remember correctly his opinion is that they don't make much difference in the end and increase the likelihood of hematomas. If I got that wrong and I find out differently I'll post an update. My lower lip is still paralyzed, no movement whatsoever, however the disport has evened things out a bit and I don't look so odd, although if you actually look at my mouth when talking you can see the asymmetry and its difficult to talk, and I discovered today that I can't whistle the special call I have for my 16 year old dog who doesn't hear much but always comes to my certain whistle.

I went to see my chiropractor on Saturday to see if he could do anything to help my lip along. He didn't really have a lot to offer, but does have a low level laser machine that is supposed to help nerves, tissues and muscles heal faster, so he suggested we try that for a couple of weeks, 3 times per week 15 minutes per session. I've only been once, but did feel some tingling, and electrical like stimulation after the first treatment, but the lip still doesn't move down. I go back on Wednesday. I know its a waiting game, but at $20 per session if it speeds things along it will be money well spent.

I still feel the implant like its sticking out on my right side, and up higher, but if I look it does not look asymmetrical, my PS says its just my anatomy. However the implant on both sides is causing a strange new line kind of inside the marionette lines that goes down on either side of the implant and takes a turn towards my jaw. Looks like eventually I'm still going to need some fillers in my lower face which I was hoping to avoid post surgery. I'm still convinced I'm going to be pleased with the end result as long as my lip starts working again, but I'll admit I'm getting a little nervous going on 3 weeks with no return of function whatsoever.

3 Weeks today and getting quite depressed

I planned this surgery a month in advance of a major function I have to attend on April 5th figuring I was giving myself enough buffer room for any residual noticeable swelling or bruising. WRONG! I'm down to 6 days before I leave for a trip 600 miles away to see people I haven't seen in years and I look like I've had a stroke if I smile. The Dysport helped a little but I still look odd and can't talk right. I tried to get out of a work presentation this week explaining my lip paralysis (I asked a week in advance) and all my boss said was "Surely it will be better by next week" but it wasn't and I had much difficulty and I'm sure our company Board of Directors either thought there was something wrong with me or I was intoxicated as I tried to give my budget presentation. Last night I called for pizza and the girl that answered the phone gave the phone to somebody else to finish taking my order because she couldn't fully understand me, this is one F'd up situation, in which is possible I could loose my job over. While there are laws that protect people with "disabilities" you still have to be able to perform your duties with accommodations, if people can't understand what I'm trying to relate, what accommodations are available? I didn't fess up to cosmetic surgery, I blamed it on an accident, but at some point I'm going to have to come clean if this doesn't hurry up and get better, and not sure how my employer will respond. In addition the dent on the right side of my jaw line is still quite prominent. If you were to take your thumb and index finger and lay them across your chin and jawline as an extended anatomical chin implant would lie (of course your hand span is bigger) imagine one side laying flat and blending into the jaw line, now take your index finger and bend it at the first joint, that is my other side. If I were a betting person I'd be willing to bet that the wing has folded under on that side. If this doesn't hurry up and resolve I want to go and see a neurologist, but if I'm not mistaken my health insurance has an exclusion for cosmetic surgery complications, so I'm between a rock and a hard place. I see my dentist in April and due for a Panorex, but it seems that the implant is only slightly visible on xray from the research I've done, and I'm sure an MRI would cost close to if not more than $1K. Despite my posts I really do love my doctor and trust him, I'm sure he will see me through the end of this, as there is still a lot of healing to go, but I'm inpatient and want to know right now what the heck is going on. It would be a few months before I could have the time off work to even consider getting a revision, and how do you explain a second event under the chin when you lied about the first one to your employer? In addition I have a male friend, we have been dating for the last year but not really too serious due to some other issues going on in his life, he's been calling me the last couple of weeks and I keep blowing him off hoping that things will resolve soon, I'm probably going to loose any potential relationship here too. Depressed and don't know how to make it any better, I'm a fixer not a waiter, lol.

Update from todays doctor visit

RELIEF!!!! Finally the swelling has gone down enough that he could feel exactly what I've been feeling the last couple of weeks and now he too is quite sure that the right implant wing has folded under itself. He's going to go back in, he said he only has to open up a small section of the incision line and just flip the wing back, he said about 3 stitches worth. He would have done it right away but I'm going out of town next week and one I didn't want to go with the stitches in and two, my thought is if I have any complications I want to be close enough to get in to see him for the first week or two. So I'm going back on April 19th and he's just going to give me a little lidocain to numb the chin and get in there and flip it back down. I feel so much better knowing that he has acknowledged what I've been suspecting and we are on track to get it taken care of. Kind of bummed that my under chin incision is healing quite nice and we'll have to open it up again, but I'm sure it will heal just as well the second time around. I suspect that the nerve issue may improve a little when it is laying right, he's not so convinced but said maybe, of course the timing will be such that it may just coincidentally start improving around the same time. I've got another 4 weeks before I have any big presentations at work, so I'm hoping for some improvement by then.

Something new at 24 days post

Not much to report today, but thought I would share something unusual. In the last few days most of the numbness in my neck from the liposuction has resolved, but oddly my jawline and neck have been hurting quite a lot today for the first time since 18 hours post surgery. The only thing I can gather is that its actually been quite sore all along but the numbness kept me from feeling it, but it all really hurts today and I have little if any numbness left. It feels like my neck and jawline got a severe sunburn, but nothing new has happened accept I'm no longer numb to the touch in those areas. I'm still kind of lumpy in my neck but thankfully its not sagging and lower right lip is still not working, but I'm holding out hope that it will either recover in the next few weeks on its own or it will after the revision to flip the wing back out.

Tomorrow will be 5 weeks

Just thought I'd post a brief update, tomorrow will be 5 weeks. Not a whole lot new to report, my left side is healing well, my right side is a hot mess. Not only does it look weird and is giving me a strange new line coming down from my mouth and turning up towards my jawline, it hurts. The place where I can feel the implant sticking out is still quite sore, the other side is perfectly fine. If I turn my neck or move my mouth in a certain way it feels like something is pulling or tugging from the inside. I'm having a hard time believing this isn't related to the paralysis that has made no improvement in almost 5 weeks. I do NOT want to remove the implant, I simply want the right side to match the left side, and I sometimes feel like the marginal mandibular nerve is somehow being pinched, twisted, or otherwise compromised by the position of the implant on the right side. I'm praying my revision on the 19th will correct all of the problems in one quick procedure. My neck is still a little hard and lumpy but honestly that is not bothering me at all. I keep going back and forth from, it will be okay to its NOT okay and I have facial paralysis that may or may NOT go away. I never imagined this would happen to me and in fact during the consultation we discussed the reasons for the outside scar and the way the pocket is dissected away from the nerves basically eliminating the risk of functional nerve injury. I'm starting to panic, I can't smile right, I can't talk right, I can't eat right, I want this fixed, but know its a waiting game. I have not lost confidence in my doctor, I'm just impatient waiting for my revision and final healing. I keep looking back and thinking what could have happened and there was a point during surgery that I got a very sharp pain sensation. I jumped and my hands even went up (I was chilling and almost asleep before that). Doc told me "don't do that" and I said "sorry you must have hit a nerve or something". He said "there are no nerves there" (where he was working) so I agreed with him in my relaxed state ( I wasn't feeling much combative) and it had stopped hurting by then, and said "it must have just scared me". But in hindsight, it DID hurt, I remember the pain jolting me out of a relaxed state. I'm praying something didn't go wrong at that moment that is going to give me long lasting consequences. As I remember from my medicated state, its the same area that is continuing to give me trouble. Well, one week and one day until my revision. If you happened to be a religious person please pray for God's hands to be upon my surgeon that day and may he find the path to correcting my problems so I may be on the true road to recovery.

Revision is done

I'm happy to report that the right side now lays down like the left, yay! It was a little yucky under just local anesthesia, but I wanted it fixed so bad it was worth toughing it out. I'm bruised and pretty swollen but hopefully that won't last too long. My doc did something different today, after he pretty much thought he had it where it belongs, he brought out the ultra sound machine to double check it. I'm not sure what he could see with that but he compared the right side to the left, I'm thinking maybe he could measure some kind of thickness to ensure they were the same. Once he was satisfied the two sides matched he finished up. I can feel the difference myself already despite the swelling. Lip is still acting up but it's always reassuring after I talk to my doc and I just need to be a little more patient. He's sure the lip paralysis is from the neck lipo and said it just depends on how far down the injury happened as to how long it will take for it to come back. Now that the implant is right I feel like I'm finally on the road to recovery and hopefully by the time I heal up from the revision the nerve injury will be healed as well. My doc seemed to think he saw some slight motion in the lip that is more reassurance that this will not be a permanent injury, I can't see it but I might be overlooking the tree for the forest.

7 week update

The chin is doing great from the revision, the side that was bulged up is hugging the bone well now. Bruising and swelling from the revision is about gone, stitches come out Monday. I'll start working on the scar when the stitches come out which was healing nicely from the first procedure.

Downside - Lip is still not budging at 7 weeks, quite nervous that this may be permanent since most of what I've read says I should have some beginnings of movement, twitching or something by 6-8 weeks with continued recovery over the next several months, but I have absolutely nothing, it is just as stuck as it was the day after surgery. Will update in another week and report if anything has changed.

8 week update

8 weeks yesterday and no change to the lip paralysis plus my neck is looking worse and worse as the weeks go by. I'm close to putting this was NOT worth it but going to reserve final judgement for one more month. So much for a 1 week recovery. I'll check back in 2 weeks unless anything changes before then.

10 weeks

I'm at the 10 week mark, the chin is looking good although the scar tissue seems to be thicker at the incision line since we had to do the revision then it did the first time around, but it's positioned where I can't see it in the mirror and since most people are taller than me I doubt they notice it either unless I bend my neck back. I want to think the lip is slightly improving I still can't pull it straight down to show my bottom teeth but I can make it move out and down if that makes any sense, I don't think I could do that a few weeks ago, although it's possible that I'm compensating and just using what movement I have differently. I think the next couple of weeks will tell me if it's really improving or I want it to so bad I'm imagining things. My smile is still crooked but the lip doesn't seem to be pulled up as tight or I'm just getting used to it. While I don't like the way my neck is looking it still feels like it has some healing to go, it's not that it's sagging, it's not but I have a lump on one side and lines, it just doesn't look natural. My right side looks better so I'm hoping if the lump on the left side resolves it will look the same and that I could live with for a while. Will check back in at the 3 month mark.

10 week pic

Forgot to include an updated pic

Coming Up on 12 Weeks and ready to finalize this review

I've had a lot of ups and downs with this procedure, my lip is finally recovering slowly, but I have every expectation that all function will return to pre-surgery level over the coming months. I also have a swollen salivary gland in my neck that I'm hoping just got a little traumatized and will settle down as well over the coming months. With all that said, I know I could still use a neck lift, but that will have to wait a little while, but this final before and after comparison sealed the deal, it was DEFINATELY WORTH IT!

Just wanted to follow up at 3 months today

I know I've closed this review as worth it, but those that have followed know I've had some complications, just thought I'd follow up at the 3 month mark that was June 7th (yesterday by about 45 minutes). My lip is DEFINATELY coming back, no doubt about that, I'd say it is 90% back to normal as of today. Me and my PS are probably the only ones that could even tell the 10% lack of function because we know and are looking for it. If it didn't get any better than this, I'd be fine with it, it would be slightly quirky but ok. The neck, eh, I actually had a very physically exhausting day today where I sweated for hours getting some things done, and I swear I think some of the swelling in my neck went down today, which leads me to believe that the neck issues that have been bothering me will resolve in time. No, I can't turn back time, but I can always do the most I can to feel good at whatever point in my life I'm at, and being I'm seeing 2 men that are 6 and 9 years younger than me respectively, I'd like to hope that its working in my favor, lol.
Fairfax Plastic Surgeon

Dr. Centeno is wonderful, I did have a few minor complications but he stuck with me, always showing a wonderful bedside manner even when I was doubting what I had done to myself. He is truly a talented surgeon and I would not hesitate to have another procedure with him.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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