Chin implant removal and chin muscle flexing. Is it normal? (Photo)

Question

Large size silicone chin implant removed, it’s been 2 1/2 months now and my chin muscle still flexing (muscle contraction). When it's flexing, my chin is deformed. It looks very scary :( My surgeon said it’s normal, he did say it will take another 2 months for the symptoms to disappear. I am still scared. How long will this last? Will my chin go back to normal? Is this even normal? Thank you so much

Michael P. Morrissette, DDS, FACS · Answer

Thank you for this question. A chin implant that was recently placed and then removed usually returns to the original chin shape and animation within a few months. Your case may be different if the implant was placed years ago. You didn't state the reason for it's removal. For now, I would consider botox to decrease the animation of the mentalis muscle and perhaps some filler to fill in the lateral chin area.

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

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  You didn't mention whether the chin implant was placed and/or removed through the mouth or using a small, curved incision under the chin (my preferred placement method).  Removing a silastic chin implant through an incision under the chin is quick, safe and highly effective with very minimal dissection which in turn should not create deformation(s) to the mentalis muscle (chin muscle).  Using this approach should allow for very rapid healing resulting in the chin and chin muscle returning as it was prior to the chin implant placement, especially when the implant was in such a short period of time.  However, if the implant was placed and/or removed through the mouth...this means the muscle attachment to the chin bone was severed, the tissue over the entire chin has to be dissected in order to properly place the implant wings along the lower edges of the chin which may explain deformations in the muscle.  Your surgeon is the only one that knows how the procedure was performed. When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  
 In my opinion and experience there is no need to secure a silastic chin implants with sutures and screws when the following conditions are met:
 * Select a silastic chin implant ( I prefer the EAC) that doesn't have too much projection (thickness) as this becomes a problem stabilizing the implant under the periosteum when the implant is too thick.
 * Place the implant through a small curved incision under the chin which allows direct access to the periosteum (under the mentalis muscle) while preserving the muscle attachments.  This prevents upward migration of the implant which can occur when the intra-oral approach is used that severs the muscle attachments.
 * While the center or body of the chin implant should be placed at a perpendicular angle the chin bone in order to provide the proper forward projection to the chin, the "wings" of the implant should be at a lower level and follow the inferior (bottom) edge of the jaw line on either side of the chin.  When properly dissected and placed, this will be below the mental nerve foramen and be just wide enough of a dissection to accommodate the tapering wing.  There isn't enough room in this technique to allow the wings to migrate upward and contact the mental nerve.  In contrast if the dissection, along the sides of the chin (jaw line) are performed too high...this will place the mental nerve in danger and if the side dissection is too wide, the wings will have a space within which to migrate upward.
 * We have all of our chin implant patients avoid touching and feeling their chin implant for 1 month post op.  We also ask that they sleep on a U-shaped airline pillow for the same time.
  Our experience when following the technique described above is that the silastic chin implant does not need to be secured with sutures or screws and does not move.  I have placed silastic chin implants in military, SWAT, LE, professional fighters, as well as actors and many regular people who are active.  In addition, I have had the opportunity on numerous occasions to replace silastic chin implants (placed by others) that had been screwed into the bone.  During the replacement it was evident that the metal screws pushed right through the soft silastic implant as it was tightened down on the hard chin bone.  Which makes perfect sense.  So in the long run, these fixation methods alone are no guarantee that the implant won't move.  Proper placement, proper implant pocket creation and meticulous closure of all the tissues layers is what is required in my humble opinion.
 I prefer placement of a  silastic chin implant through a small, curved incision under the chin (submental) instead of through the mouth for the following reasons:
*The submental approach is sterile while the intra-oral approach is not.
*The submental approach requires limited dissection as it is much closer to where the chin implant needs to be placed along the center (front) and lower most sections of the chin on each side (where the wings are placed).  The intra-oral approach by contrast requires dissection all the way down the entire section of the chin in order to reach the same areas for chin implant placement.  This leads to several issues in my humble opinion.  The attachment of the chin muscle to the bone must be cut during the tissue dissection, the sensory nerves (mental) and motor nerves (marginal mandibular nerve) that move the muscles of the lips and mouth) are all in much greater jeopardy of injury because of the added dissection required.
 There are numerous shapes and sizes of silastic chin implants, some of which are rather old shapes that do not yield the desired "natural" aesthetic results.  The Curvilinear shape is an example that is similar to the old "button" implants (had no wings or lateral tapering elements of the newer EAC design) that created a "pharaoh" shaped chin.  Proper placement and the appropriate approach (placing the incision under the chin and not inside the mouth) are also key to obtaining the best aesthetic result.Hope this helps.

Chin implant removal and chin muscle flexing. Is it normal? (Photo)

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Chin implant removal and chin muscle flexing. Is it normal? (Photo)

Answers (2)

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Everything you need to know about Chin Implant

Our mission is to create a world where every investment in modern beauty is Worth It.