Chin Implant Replaced and Now Limited Lower Lip Movement

Question

About 4 years ago I got a chin implant. The implant was fine but not as large as I hoped for. 3 weeks ago I had the chin implant replaced with an larger implant that gave me more anterior projection and jaw line. Today, 3 weeks after the surgery the bulk of the numbness is gone but my bottom lip is not functioning properly. When I smile my bottom lip stays still blocking my bottom teeth. Is this something permanent? Will I ever get my old smile back?

Stephen Prendiville, MD · Answer

A described complication of chin implant placement is temporary or permanent injury to the sensory nerves that supply the lower lip. The condition described in this scenario sounds like a weakness of the motor nerve that supplies the lower lip (marginal mandibular branch of the facial nerve); injury to this nerve is very unusual because it is much more superficial and lateral to the plane of dissection for a chin implant. If there is a weakness to this nerve, it is likely related to swelling and should resolve reliably over time. Oral steroids (prednisone) can be beneficial in this scenario. I recommend you keep in close contact with your Surgeon for monitoring and reassurance.

Kevin M. Robertson, MD, FACS · Answer

The larger implant and the swelling from surgery are the most likely cause of the decreased mobility. I doubt it has anything to do with your motor nerves. As with any tissue expansion, the elasticity of the overlying skin and muscle will be reduced for a period of time, and you are only three weeks out. As your body resolves some swelling, and stretches to accommodate the larger implant, your elasticity will improve. And that's when your smile will be back as well. It will be a few more weeks, but stay patient.

Nima Shemirani, MD · Answer

Dear SanDiego,

	It can be hard to differentiate numbness and movement of the lower lip.  It is pretty rare to have an injury to the nerve that moves your lower lip just because that nerve is located near the angle of the jaw, and not in the midline where most chin implants are placed.  The decreased movement of your lower lip is probably due to swelling and should resolve over time.  3 weeks is still pretty early and it looks like you are still going through changes.  Just be patient, your body is just getting used to the bigger implant.

	Best,

	Nima Shemirani

Neal Goldberg, MD · Answer

There is no definite yes or no here. To reassure you, however, the larger implant may be causing temporary swelling and pulling on the nerve going to your lip. Even at three weeks the overwhelming likelihood is that your function and sensation return to normal.

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

At 3 weeks after a Chin Implant removal and replacement, it's not unusual for your lower lip movement to feel impaired. I've used Chin Implants for over 20 years, it can take 3-4 months for the lip to feel like it did before the surgery...I wouldn't worry until then. Numbess is also possible and typically resolves in several weeks.

Richard W. Fleming, MD (retired) · Answer

The limited motion of your lower lip is not secondary to nerve injury. Severe temporary swelling after surgery is the most likely cause - this will resolve. The chin implant is placed in front of your jaw bone below the lip; with a large implant it could extend into the lip. If this is the problem the implant would have to be repositioned or reduced.

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