Chin implant revision/ US, Europe

Question

2 years ago I underwent a revision procedure to remove my chin implant due to an increase in the squaring of its contours. The protruding wings of the new implant have rendered my facial profile excessively broad, resulting in a widening of my lower face. I am looking for the experienced practitioner who specialize in implant replacements.  Is it possible to excise only the wings of the implant without necessitating a complete removal?  Also any qualified surgeons in Europe ? thank you

Gary M. Horndeski, MD · Answer

It is possible to revise the implant by shortening the wings.  The implant has to be removed, shortened and then replaced.  It would take 1 hour to perform under general anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Eric M. Joseph, MD · Answer

In more than 90% of people that we place chin implants, we advocate for anatomical chin implants that lead to a tapered chin appearance, rather than a wider chin appearance. It is relatively straightforward to do an implant exchange from an extended version, to a tapered version. Though it may be feasible to remove the wings of what you currently have now, I believe putting a clean sterile and fresh implant in would be the safest option compared to taking out what has been inserted, trimming it, and reimplanting it. I would suggest leaving your surgeon close to home, especially after what you have been through. Wishing you well moving forward. Sincerely, Dr Joseph

Lucian Ion, FRCS · Answer

Thank you for your question. It is unlikely to be possible to adjust the implant without taking it out. It is, however, possible to remove the implant, contour it, and put it back in. It depends to a degree on the material of the implant, which, from your description, is more likely to be either medpor or PEEK. Sometimes the implants are damaged when they are removed, and as a result having a backup of a replacement implant is relevant. One of the limitations regarding adjustment of the implants in place is that the tip of the wings of the implant is just below the inferior alveolar nerves, making it very risky to work on the implant because of the possibility of damaging the nerves.

Jeffrey H. Spiegel, MD · Answer

This is a common request in my practice. We should be able to adjust the implant without needing to fully replace it.  Much of the time this can be done right in the office and takes about 30 minutes.

Mats Hagstrom, MD (license on probation) · Answer

If your implant is made out of silicon, then it can very easily be manipulated with parts of it shaved off or removed.
If you have a porous type implant, then removing it or manipulating, it is going to be more difficult.
Posting on this website is probably not the best way to find the right provider for your needs.
Finding the right plastic surgeon is difficult, time consuming, and in reality most patients don’t do a very good job at it.
It is a difficult task.
 to find the best provider for your needs you start by making a list of potential providers in your community.
Do not overlook providers who don’t have a strong Internet presence.
Some of the best plastic surgeons have no interest, promotion or posting on social media.
Some of the best plastic surgeons I’ve ever known had virtually no Internet presence.
One of the very best facelift surgeons I know doesn’t even have a website.
Regardless make potential providers.
Next contact the providers offices by calling them or sending emails.
It would be ideal if you can send an email directly to each of the providers.
Ask how many cases or what their experiences been with complex shin implant revision surgery
Considering that this will be your third procedure recognize that at this point thinks may be more difficult and complex.
Each time you have surgery things become more complex and potentially more difficult.
Next schedule in person consultations with each of the providers.
Bring a complete set of facial pictures to use as a reference during the consultation.
Do not rely on memory or looking at mirrors for reference of what your face looks like.
Next asked the provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar facial characteristics and had similar procedures.
If the provider has done a lot of revision work, ask them to show you the results of those cases.
 Recognize that it’s your responsibility to the provider.
While the provider is assessing you for your surgical needs you are at the same time interviewing someone you’re about to hire for a service.
Recognize that it’s your responsibility to vet the provider in regards to skilled experience.
When it comes to plastic surgery skill, being famous does not equal being talented.
Looking for providers based on the reputation can give you next results
I’ve known Many famous plastic surgeons who I would never choose to operate on friends or family.
The more plastic certain you consult with the more likely are to find the better provider for your needs.
Having only one consultation and then scheduling surgery, more or less eliminates the ability to choose a better provider.
I do not think patients can attic select providers by using the Internet.
Finding the right provider requires having multiple in person consultations.
Average plastic surgeons deliver average work.
Only exceptional plastic surgeons do exceptional work, and finding exceptional providers can take some effort and sometimes we simply miss.
Perhaps the best source of finding the best providers is to ask people in their fields.
Asking a plastic surgeon who they think is best may be an awkward thing to do since in a sense you’re asking the provider to steer you towards their competition.
In the end, provider selection is the most important variable for almost all plastic surgery procedures.
It is also one of the most difficult things to do and in general patients do a terrible job at it.
To find the right provider requires a substantial amount of effort, including a commitment of time and potential expense.
You should also ask yourself if you really need somebody who is exceptional for simply having part of your implant removed.
Good luck,
Mats Hagstrom MD

Chin implant revision/ US, Europe

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