Chin Implant: Screws or None?

The pocket is usually made under a thin but strong membrane called the periosteum with the pocket made to the exact size. The pocket then shrinks down around the implant to hold if firmly in place and it will feel just like your chin - you will not be able to wiggle it. A a screw is not usually used for silicone implants (the most common type) but is used for others such as PTFE, Gortex, etc.

         The chin implant is placed directly onto the bone and feels like an extension of the bone.  The soft tissue is dedraped over the implant.  Pocket dissection needs to be done precisely so that the implant has little chance of moving either early after surgery, years after surgery, or after trauma.  Screws are not necessary but may be more useful in revisions.  Kenneth Hughes, MD Los Angeles, CA

I have not found screws to be helpful and have found that screws can occasionally create issues of their own (backing out, can be felt, extrude). If the implant is properly positioned and a small pocket is created that retains the implant in proper position, fixation is typically not required. I hope this information is helpful.Stephen Weber MD, FACS
Lone Tree Facial Plastic Surgeon

Some surgeons do use a screw to secure the implant in place during chin augmentation surgery.

I personally don't find this necessary, however. I find that creating a precisely sized pocket and placing a  dissolvable suture through the silicone implant to temporarily secure it to the overlying tissue is sufficient. With a properly size pocket the implant won't have anyway to migrate to and you should be able to wiggle it once it heals in place. The edges of the implant usually obsure well under the overlying skin and muscle.

You can read more about chin augmentation surgery at my web reference link below:

I've been doing chin implants since 1988, more than I can recall. Never used a screw because they are unnecessary. The implant pocket should be made like a foot in a shoe; if done correctly the implant has no place to go. Have only repositioned one in all that time. Always visit more than one surgeon; seek a facial aesthetic specialist, look at lots of photos and go with the surgeon that makes you feel most comfortable.

 Chin implants,  come in a variety of sizes and shapes, and are inserted through a small  submental incision. A very precise pocket is made over the front part of the mandible and the implant is inserted directly over the bone and  inside that precise pocket. Very rarely does it ever shift, move, or migrate. Screws are not required although a stitch can be sutured at the central portal implant to hold it down to the periosteum.

Having done facial cosmetic surgery for over 35 years I've used different techniques to place and secure the position of a chin implant. Screws are not necessary. It would take tremendous force like an automobile accident to move the implant after it has healed and you will not be able to feel or move it. Depending on the design of the implant, surrounding soft tissue will grow into the implant but not the bone.  

I have never found it necessary to screw in a chin implant. Unless a very small implant is placed in a very large pocket, screw fixation should never be needed with a one piece silastic chin implant. 

After putting in chin implants for 30 years I have yet to fix one in place with a screw. That would be very uncommon. The surgeon makes a space in the tissues right on the bone surface and that space is created gradually until the implant just barely fits. There will be no movement and no chance of displacement.