What is the % success rate of chin implants?

Question

Everywhere I look, plastic surgeons always say that the success rate is high and the complication rate is very low "in the right hands". This is frustrating to me because I want want to know what high success rate means. Does anybody have any number statistics based on a large sample size? If not, in your experience doing this procedure, roughly how many bad procedures have you had happen. I consider a complication to be major asymmetry and infection.

Jeffrey H. Spiegel, MD · Answer

Chin chin and cheek implants have as their primary complications infection or malposition. We do many many implants and I have not ever had someone with a chin implant infection 4 position problem. Some people do them from underneath the chain but I prefer to go inside the mouth since we get no visible scarring. Watch our videos to learn more.

William Portuese, MD · Answer

In our practice for over 28 years, we have seen two infections from chin implants which had to be removed. They can be replaced later at two or three months once the body has healed. Major asymmetry is not an issue as long as the surgeon recognizes that preoperatively   ahead of time to match patient's unique anatomy. We have had three or four patients who had a small area of numbness which was permanent.

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.  I'm certain that you could do a quick internet or library search on scientific journal papers regarding the success rate of silastic chin implants placed through a submental incision (under the chin).  Im my experience using this approach for over 30 years, there have been a couple of localized infections of the skin incision but none of the implants themselves were infected requiring their removal. It might sound trite but it is true that the success, which would include rate of infection, malposition and satisfaction with the aesthetic result is directly associated with the proper placement of the correct sized and shaped chin implant.  This in turn is directly proportional to the experience of the chin implant surgeon.  Take for example the difference of placing the implant through a small, curved, incision under the chin (a sterile approach) versus placement through the mouth (not sterile).  This would impact numerous aspects of the chin implant surgery success (as discussed below).  In addition the large and very large sized implants require a larger implant pocket that is associated with increased dissection, increased likelihood of sensory nerve impingement and decreased ability to provide a natural aesthetic results...especially in women.   Finally, the more experienced the chin implant surgeon the less surgery time required.  There is a direct correlation of surgery time to increased rates of post-op issues including increased swelling, bruising, discomfort and infection.  Finally, the degree of activity post-op activity especially strenuous activity will directly affect the risk of bleeding around the implant which is likely one of the most common causes of chin implant infections when using the submental approach.  We advise refraining from strenuous activity or taking blood thinners (prescription or supplements) for 1 month post-op.  All of this should be covered and discussed during your chin implant consultation. 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.
*The added areas of dissection with the intra oral approach allows upward migration of the implant as well as an increased risk of nerve injury.  Damage to a sensory nerve will create numbness and or an ache type discomfort while injuring the motor nerve will result in an inability to "lower" the corner of the mouth and lower lip.  
 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.  The EAC or extended anatomical chin implant style offers, in my experience and humble opinion, the most natural, aesthetic result when augmenting the chin.  The EAC in a size small is the most common implants that I use in women ( size medium in men ).  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.

Jay M. Pensler, MD - Account Suspended · Answer

The complication rate is in the range of 1% in individuals who are experienced. The issue is a chin implant augments the chin in a specific manner depending on the implant and position of placement. An  implant does not alter the occlusion ( position of the teeth) or the temporomandibular joint.

What is the % success rate of chin implants?

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What is the % success rate of chin implants?

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