Bone Erosion Associated with Silastic Chin Implant

For most of us facial surgeons, placement of a chin implant is an extremely gratifying procedure. Chin implants can greatly improve facial harmony and they will truly benefit  the patient for decades to come.

Having said this, every surgical procedures comes with risks. Personally, I do not consider bone erosion a risk after chin implant. It rather demonstrates the dynamics of our bones over time. The chin becomes less projecting with time anyway, mainly due to soft tissue changes. The overall benefit from a chin implant will persist even if there is some bone erosion. Therefore, bone absorption after silastic chin implants represents an issue of a rather academic interest; but it is still your face after all. Some patients ask me if we should choose a larger size chin implant to overcome a possible absorption of bone. I do not think that this is a good idea.

Although reported at low incidence in the literature, I have not found this to be a problem (ever) in over 15 years of performing Chin Implant surgeries with Silastic. I would not be concerned with it. Dr. G.

Any implant, including breast implants, can cause bony erosion or remodeling. To some degree also be aware that you will naturally lose bone volume and density with age. That having been said, there are several factors that determine the amount of bone erosion and this is essentially comes down to movement and pressure. Some surgeons beleive that fixation of the implant minimizes erosion. Furthermore, putting a very large implant in a tight skin envelope will likely create greater forces that will promote greater erosion than a smaller implant. Therefore some surgeons prefer to limit the size of the implant to 5-6 mm of projection.

After placement of a chin implant, animal studies have demonstrated minor bony erosion.  However, other studies looking at the bone radiographically in humans contest this.  Nevertheless, a study by Binder showed that the aesthetic consequences of minor bony erosion after chin implantation are trivial and should not effect the overall result. 

While some chin implant procedures do tend to cause a small amount of bone erosion, the amount of erosion is usually only a few millimeters over time. The implant can always be removed later in life if so desired. It will not really affect the long term results.

The incidence of  bone erosion used to be more common with the old implants. It is probably less common with the new anatomic implants. Pressure is probably the most common cause of erosion of bone.

There are other options that silsastic implants that may have less chance of bone resorption.

Also osteotomy and chin advancement is another possibility

Silastic implants are associated with bony resorption which many surgeons believe is due to either the implant or the pressure placed by the implant, especially when placed, as many are, in a pocket under the lining of the bone. Another option may me to try filling the chin with a long acting filler such as Radiesse and see if you like it. If you do not, it will be gone in a year or so. If you do you may wish to consider a Porex implant which requires fixation to the chin bone. These implants do NOT move and allow tissue ingrowth.
Dr. Aldea

Hi Andrews,

As noted, studies have shown bony erosion after chin implant is negligible, around 1mm or so in thickness. This is really remodeling of the bone edge from pressure or separation from the overlying periosteal layer. This change translates to an even smaller cosmetic effect when covered with the implant and overlying soft tissue since the three-dimensional change in volume is very small. So, you should have no reason to worry about long-term effects.