Chin Implant: Screws or None?

Question

Hello, I am considering getting a chin implant in the future. I don't like the idea of a screw in my bone (whether its safe or not its still not for me), however I have read that implants without one can move even after healing. If I choose one without screws will I be able to feel the edges of it or be able to "wiggle" it? Also, I have read that it can shift if you get hit in the face. And contradicting all this I have read that the bone "grows" onto the implant without screws. Is this true?

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

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.

Kenneth Hughes, MD · Answer

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

Stephen Weber MD, FACS · Answer

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

Thomas A. Lamperti, MD · Answer

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:

Sean Freeman, MD · Answer

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 Implant: Screws or None?

Answers (5)