Please help! Extreme swelling/muscle pain/restricted movement 11 days after a chin implant -- should I be concerned? (Photos)

Question

I had a silicone chin implant placed with under-chin incision 11 days ago. In the last 24/48 hours I'm VERY concerned. My swelling has drastically increased, the muscles under my chin (and even down my neck) are very sore, I struggle to smile/chew/open my mouth and even swallowing hurts the under-chin muscles. My PS is saying take acetaminophen and apply warm compress. Can someone please tell me if I should be concerned? Note that I had NO signs of double chin before, just receded chin.

Jonathan Kulbersh, MD · Answer

There can be a fair amount of swelling after a chin implant, which will gradually resolve over several weeks to months. I recommend following up with your surgeon. If your implant is asymmetrical, it can be re-positioned with a surgical procedure. I hope this helps.

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You submitted two photos, and state you had a chin augmentation about 11 days prior,  which was uncomplicated. However, in the last 48 hours, you developed significant swelling, and struggling with smiling, chewing, and movement. You state your plastic surgeon told you to take acetaminophen and apply warm compresses. You’re looking for some guidance on what to do given this change.
I can share with you my perspective limited by a lack of a physical examination. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Helping people improve the appearance of the chin is part of my daily practice, whether with a chin implant like you had, or with injectable fillers through a method called Structural Volumizing using injectable fillers. 
With chin implants, for any specialist who performs this surgery, it’s generally straightforward procedure. After a small incision is made under the chin or from inside the mouth, a silicone type of implant is generally placed under the periosteum which is a layer overlying the bone. Once it’s placed, it can be fixated, and usually stays in place without any problem. Most people feel pretty good even a week out, but they can have some mild swelling, and a little irregularity with facial movement. 
Chin implants are not without complications and problems. Even well-respected surgeons with tremendous experience will periodically have problems with implants. Sometimes, things just don't go the way you expect, and you can have a problem such as bleeding or infection.
What raises a red flag for me is  in the short course of 48 hours, or about 9 days after your surgery, you had a sudden change and worsening of symptoms to the point where you are struggling to move your mouth. That doesn't sound right, and you describe you didn't have a double chin before the procedure, which indicates a significant amount of swelling. 
With your doctor advising you about the acetaminophen and the warm compress, you didn't clarify in your question if whether or not your doctor examined you. It is very important for your doctor who performed the surgery to examine, evaluate, and feel this area. This doctor knows your face and your anatomy. If you are dealing with some bleeding, or the onset of an infection, the only one option is to remove the chin implant. 
It’s very important you see your doctor in person. If your doctor isn't available, see another doctor. These kind of symptoms are very concerning, and should not be minimized as something that’s normal. For an uncomplicated process of chin augmentation, it is routine for our patients to feel really good. A week later, we take those stitches out, and they really love their appearance; two weeks later, they look even better. This sudden change is concerning and I would really encourage you to see your doctor in person to examine you because there is no clear basis that could be justified for a normal course of healing that would involve a sudden worsening of symptoms as specific as yours. I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed chin implants surgeries for over 30 years.  In my experience and humble opinion you should not be having any "extreme" symptoms following chin implant placement during the post op period.  While these occurrences are exceedingly rare, in the hands of an experienced Chin Implant Surgeon, dramatically increasing pain or swelling might indicate an infection or bleeding within the surgical area and should be ruled out.  You may wish to follow up with your Chin Implant Surgeon in person.Hope this helps.

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