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.
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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