I had a silicone implant removed that was about 10mm long. I’ve got pretty intense dimpling on my chin when I close my mouth. I also think my mentalis nerve is messed up. My chin isn’t numb but the sensation is different in my lower lip, chin, and lower gums. Is it a big risk if I get another smaller implant to give me back some projection and smooth out the dimples on my chin? I’m worried I’ll do more damage to my mentalis nerve, make the muscles in this area weaker & not fix the dimples.
Answer: Orange Peel / Pebble Chin / Chin Dimpling -- Botox/Dysport/Xeomin/Jeuveau to Mentalis Muscle Treatment for chin dimpling ("pebble chin" or "orange peel") is Botox injected into the mentalis muscle. This typically gives great improvement to the appearance of the chin. Results take about 1 to 2 weeks. I suggest getting a formal evaluation with a board-certified cosmetic dermatologist. Best, Dr. Emer
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Answer: Orange Peel / Pebble Chin / Chin Dimpling -- Botox/Dysport/Xeomin/Jeuveau to Mentalis Muscle Treatment for chin dimpling ("pebble chin" or "orange peel") is Botox injected into the mentalis muscle. This typically gives great improvement to the appearance of the chin. Results take about 1 to 2 weeks. I suggest getting a formal evaluation with a board-certified cosmetic dermatologist. Best, Dr. Emer
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July 24, 2023
Answer: Implant vs Genioplasty Unfortunately removing chin implants can leave dimpling and ptosis. As for the nerve issue, having some sensation is a good sign. Nerves can take a long time to fully recover, however they can leave people with less sensation. The biggest issue would be if you were having any nerve pain. When it comes to a revision, there is a slightly higher risk of complications, especially with nerves that have been damaged or are not fully healed. That being said, you might consider a genioplasty instead. It is hard to tell without a profile picture to see where your chin is compared to the rest of your face, but we almost always recommend a genioplasty over an implant. It is a bigger procedure, but it also provides more benefits. It would fix the dimpling and add the projection you are looking for. It would also elongate your jawline. This is all done without an implant, which many people prefer. Our office offers virtual or in-person consultations if you would like to discuss things further!
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July 24, 2023
Answer: Implant vs Genioplasty Unfortunately removing chin implants can leave dimpling and ptosis. As for the nerve issue, having some sensation is a good sign. Nerves can take a long time to fully recover, however they can leave people with less sensation. The biggest issue would be if you were having any nerve pain. When it comes to a revision, there is a slightly higher risk of complications, especially with nerves that have been damaged or are not fully healed. That being said, you might consider a genioplasty instead. It is hard to tell without a profile picture to see where your chin is compared to the rest of your face, but we almost always recommend a genioplasty over an implant. It is a bigger procedure, but it also provides more benefits. It would fix the dimpling and add the projection you are looking for. It would also elongate your jawline. This is all done without an implant, which many people prefer. Our office offers virtual or in-person consultations if you would like to discuss things further!
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July 21, 2023
Answer: Chin implant removal The occurrence of dimpling of the chin is one of the possible effects after implant removal. Some botox to the mentalis muscle should help. You didn't say why the implant was removed, but if you want a natural looking chin with added projection you should consider a sliding genioplasty.
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July 21, 2023
Answer: Chin implant removal The occurrence of dimpling of the chin is one of the possible effects after implant removal. Some botox to the mentalis muscle should help. You didn't say why the implant was removed, but if you want a natural looking chin with added projection you should consider a sliding genioplasty.
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July 21, 2023
Answer: Chin dimpling I am not sure why you removed the implant. But by so doing, the mentalis muscle dropped backwards and the vector of closing your mouth is probably at an angle now and not as vertical. Because it's at a less favorable angle, it has to work harder and hence the dimpling! In my experience, implants tend to lessen the dimpling because they move the mentalis into a more favorable vertical position. Also, I would think that injecting the area with filler would not move the mentalis into a more favorable position, but would give you some augmentation and may also mask the dimpling. Regarding damage to your mental nerve and muscles in the area...The implant should have been placed in a subperiosteal plane and that is beneath the muscles. However, it is true that a change in the location of the periosteum to which the muscles attach, could affect the movement somewhat. I have seen more issues with an intra-oral approach rather than a submental approach. Finally, a capsule with scar tissue forms around the implant and may encroach upon the sensory (mental) nerves. So dissection in the area to remove or re-insert an implant has the potential of causing damage to the sensory nerves in the area. It is wise to use a surgeon who is experienced in doing this type of surgery!
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July 21, 2023
Answer: Chin dimpling I am not sure why you removed the implant. But by so doing, the mentalis muscle dropped backwards and the vector of closing your mouth is probably at an angle now and not as vertical. Because it's at a less favorable angle, it has to work harder and hence the dimpling! In my experience, implants tend to lessen the dimpling because they move the mentalis into a more favorable vertical position. Also, I would think that injecting the area with filler would not move the mentalis into a more favorable position, but would give you some augmentation and may also mask the dimpling. Regarding damage to your mental nerve and muscles in the area...The implant should have been placed in a subperiosteal plane and that is beneath the muscles. However, it is true that a change in the location of the periosteum to which the muscles attach, could affect the movement somewhat. I have seen more issues with an intra-oral approach rather than a submental approach. Finally, a capsule with scar tissue forms around the implant and may encroach upon the sensory (mental) nerves. So dissection in the area to remove or re-insert an implant has the potential of causing damage to the sensory nerves in the area. It is wise to use a surgeon who is experienced in doing this type of surgery!
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July 21, 2023
Answer: Think Robust HA Filler For Nonsurgical Chin Augmentation Putting aside the fact that you would likely have had less of a problem now had you decided upon the use a robust HA chin filler in the past, right now, you can certainly consider the use of an appropriate filler to augment your chin to provide smoothing and projection. Yes, I am aware that when you opted for a silicone chin implant, you likely did not take into account that complications necessitating removal would later occur. And, also likely you had the mistaken notion that a silicone implant would give you a one-and-done permanent correction. While it is true that the silicone implant is permanent, the cosmetic benefit is not; the inevitable, age-related loss of muscle and bone with time typically necessitates removal and replacement of the implant usually in just a few years. Let this be a word of caution to other readers of this response when being hawked surgical implants for chins, cheeks, etc. Fortunately, in the hands of an experienced injector, an appropriately chosen, robust HA filler can provide the kind of smoothing of the current dimpling and projection desired. You would be wise to consult a board certified cosmetic dermatologist and best of luck.
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July 21, 2023
Answer: Think Robust HA Filler For Nonsurgical Chin Augmentation Putting aside the fact that you would likely have had less of a problem now had you decided upon the use a robust HA chin filler in the past, right now, you can certainly consider the use of an appropriate filler to augment your chin to provide smoothing and projection. Yes, I am aware that when you opted for a silicone chin implant, you likely did not take into account that complications necessitating removal would later occur. And, also likely you had the mistaken notion that a silicone implant would give you a one-and-done permanent correction. While it is true that the silicone implant is permanent, the cosmetic benefit is not; the inevitable, age-related loss of muscle and bone with time typically necessitates removal and replacement of the implant usually in just a few years. Let this be a word of caution to other readers of this response when being hawked surgical implants for chins, cheeks, etc. Fortunately, in the hands of an experienced injector, an appropriately chosen, robust HA filler can provide the kind of smoothing of the current dimpling and projection desired. You would be wise to consult a board certified cosmetic dermatologist and best of luck.
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