Chin Implant Removal Years Later?

Question

I had a chin implant placed in my chin through a small one inch incision underneathe my chin six years ago in 2006. I'm thinking of removing it. I'll probably have the surgery in 2013, so seven years since my operation. If I have it removed so long after the initial procedure, will there be difficulty with the skin contracting back over my real chin? Additionally would it be a bad idea to get an X-ray of my lower jaw to see how much of my chin is silicone vs. natural? Would that even work?

Larry S. Nichter, MD, MS, FACS · Answer

Chin Implant removal information/and considerations: For the vast majority of chin implants, removal is straight  forward most commonly using the  same incision that was used to place it. The procedure is often done in the office with local anesthesia with or without some sedation, but also commonly done in the OR under IV sedation or general anesthesia per patient's and surgeon's preference.  Most implants are silicone and are not adherent so slip out readily. Medpor, also called PTFE, may have tissue ingrowth and can be a bit more involved but still can be removed in the same manner.  It is very helpful for your surgeon to  review your prior surgical records to know the size and type of implant used. This may be obtained by contacting your prior surgeon's office or OR facility and request your prior surgical records.
Expectations: if the chin implant was small and removed within the first few years chances are likely that you will return a similar size and shape as before. If the implant was small, the chin soft tissue usually shrinks back down without  sagging.  Often, there is still some gain once the implant is removed due to the scarring and capsule (lining your body makes around the implant) that gives some benefit. On the other hand a large implant placed many years ago, and other factors such as being elderly, having osteoporosis and perhaps smoking that can cause loss of underlying bone due to  bony erosion from the pressure of the implant. In this case  use of a natural filler such your fat or at times a bone graft may recommended for different reasons. Your surgeon may request a  Panorex or lateral cephalometric x-ray to see if this is the case.  Temporary fillers can also be tried such as Jeuvederm, Sculptra, Voluma, Volbella, etc. 
Most important of all make sure you pick a plastic surgeon with great expertise in #chinaugmentation and #chinimplantremoval. 
See the below link on how best to choose your surgeon.

Raffy Karamanoukian, MD, FACS · Answer

Most silastic chin implants can be removed easily, if appropriate.  You may consider the removal of chin implant in the context of your jowl line, neck line, amount of chin redundancy, and the quality of bone in your mandible.  Not all choices to remove the implants are suitable for patients based on these factors.

Barry L. Eppley, MD, DMD · Answer

Most likely this was a silicone implant as the incision was very small. It will be easy to remove and not all augmentation will be lost due to scar. If the implant was not too big, the chin skin should shrink back down without any sagging. Rather than an x-ray, it would be more helpful to know the type and size of the implant that was placed. This may be obtained from your prior surgical records. If this is not obtainable, a lateral cephalometric x-ray will show the bony chin and the outline of the implant on top of it.

Michael R. Menachof, MD · Answer

As long as your implant is made of silicone, it should be very easy to remove. Occasionally, some surgeons will use an implant made of a different material (gortex for example) that can be very difficult to remove. As long as you are sure that your implant is silicone, the surgery should be easy. Since chin implants are placed on top of the bone, it is not just the skin, but all of the tissue of the chin (skin,. soft tissue, fat, muscle, periosteum, etc.) that contracts back down onto the bone. This happens very naturally and generally without any problems. You will almost certainly have some resorption of bone underneath the implant but it is unlikely that you will notice this. X-rays will not be helpful. Good luck.

Richard W. Fleming, MD (retired) · Answer

First I would like to know why you are considering removal of the implant but It can be removed without problems. You may still have some increased chin projection after removal of the implant due to scarring in the space present after removal of that implant.

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