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Breakdown of Suture Line Intraoral Chin Implant? (photo)

I am 9 days post op for an intraoral silicone chin implant. Been brushing teeth and using mouthwash frequently. The suture line is breaking down in places - nurse check yesterday said it was ok but I am worried as dehiscence getting a little worse, more suture showing. Not particularly painful or red to touch apart from one focal area which is the opposite side to the breakdown. Externally looks great. Worried that the implant will get infected. Grateful for opinions. P.s. I'm a vet surgeon!

Doctor Answers 4

Wound problems best sorted out by your surgeon

December 2nd, 2012
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First of all you should not be pulling your lip as you are doing in the photos so soon after surgery as you may cause the wound to separate (dehiscence). There are some white sutures (probably Vicryl) that will be removed if they don't dissolve soon. Regular check ups with you surgeon is needed to rule out any problems such as infection (not obvious from your photo).

 

Web reference: http://pacificcenterplasticsurgery.com/procedures/face/chin-augmentation/

Larry S. Nichter, MD, MS, FACS

Wound problem after intraoral chin augmentation

November 5th, 2012
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Most wounds of the sort seen in your photos are superficial and respond to conservative rinsing of the mouth with peroxide and saline and avoidance of traumatizing the area. If the wound is not continuing to improve or opens more then you may have a rare incidence of implant exposure or infection. However, from the looks of it you will probably be o.k. Just stay in close contact with your surgeon and don't hesitate to contact him with any change in symptoms. Best of Luck  Dr Harrell

Web reference: http://www.westonsurgery.com

Jon F. Harrell, DO, FACS

Schedule a follow up appointment with your surgeon

November 5th, 2012
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Dear SophB, I would suggest frequent visits with your surgeon for follow up and continue the directions given for post operative care. If you develop any more redness, tenderness, fever etc call STAT for an appointment. I personally do not use this incision for chin augmentation due to the risk of infection. This is just a personal preference and many surgeons still use an intra-oral incision. Keep an eye on it and make frequent follow ups for the next week. Best regards, Michael V. Elam, M.D.

Web reference: http://www.michaelelammd.com

Michael Elam, MD

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 194 reviews

Wound separation

December 5th, 2012
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Fortunately, the zones of separation are small and superficial, and as far as I can see in the photos, the implant is not exposed.

1)  Don't pull on your lip.

2)  Don't brush your lower teeth.  You don't want to accidental put the toothbrush into the weak area.

3)  "Swish and spit" with Peridex, or similar oral rinse, 3-4 x per day.

4)  Continue close follow-up with your surgeon.

This should heal in a week or two.

Thomas Fiala, MD

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.