At 8 weeks from initial surgery, I feel the medium silastic chin used was too large for my face - sulcus looks too deep. I am not big on surgery and only want to do this one more time. If I downsize smaller, my doc says the old scar pocket will collapse and form around the small implant, while other docs feel it is imperative to remove the prior scar pocket?? My doc stitches the implants in, but they are not secured by screws. If I choose complete removal, what are chances of deformity?
Chin Implant Revision Vs. Removal?
Doctor Answers 4
Chin implant removal
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.
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Chin implant removal and replacement
You can have the medium implant removed or modified (by shaving). You shouldn't need to have the implant capsule removed. It should be able to shrink down around a smaller implant.
The question of whether just completely removing the implant would lead to a deformity depends on how big your implant is, how elastic your skin is and how long the implant was in place. You can discuss your options with your surgeon.
Chin implant removal or reducing size
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Chin Implant Downsizing and Implant Capsule
If the chin implant is too big, it can either be downsized or modified to be made smaller. But the surrounding chin implant capsule should not be manipulated or attempted to be remove. That will cause more problems and has no benefits to doing so. The implant capsule will shrink down around the new or modified chin implant. If the implant is completely removed, the risk of soft tissue chin sagging (witch's chin deformity) depends on how big the implant is and how long it has been in place.
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.