Is a chin implant only supposed to create a subtle difference?

Question

I feel like I liked it better when it was swollen and puffy as opposed to now after the swelling has gone down. I just don't see that much of an improvement!!! I thought I was clear to the doctor when I said I wanted it to be as big as possible...I never said I wanted a subtle difference. I clearly remember using the words "big", "masculine", "square" during the consult. Should I take it out and go bigger? Or is there a risk to re-inserting a larger one? It doesn't look masculine at all.

George Yang, MD · Answer

Hi DiamondDogs,You should have follow up photos taken and have them compared to your pre-operative photos which were taken before surgery, to see a true comparison.  The actual projection of the implant is approximately 80% of the actual chin implant, since the skin and soft tissue overlying the chin implant thins out when it is stretched over the implant.  These are my general observations with chin implant sizes.  With a small chin implant on a man, the improvement may only be a couple of millimeters, which for some patients, they may not be able to see any improvement in profile.  A medium chin implant should show a visible improvement in the chin profile, but for some patients they may still feel it is subtle.  A large chin implant usually is more significant, and if the patient were to guess on the size, they guess it was a medium.  Depending on how weak the patient's chin is some patients may want an extra-large.  I do worry about bone erosion as a possible side effect of chin implants.  I also think the larger the chin implant, the higher the risk of bone erosion.  These discussions are all part of the pre-operative planning to make sure the patient makes the best decision.Since you liked the appearance when you were swollen, most likely a single size bigger may be what you are looking for.  Luckily, it is easier to place a larger implant than to place a smaller implant.  The surgeon simply needs to remove the old implant and stretch the pocket towards the wings a few millimeters deeper so that the larger implant can fit.  The problem with exhanging for a smaller implant, is that the pocket is too big and the smaller implant will not have snug fit, and may be hard to keep the implant centered and prevent it from shifting.Best,Dr. YangP.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Jonathan Kulbersh, MD · Answer

Generally speaking, chin implants come in a variety of sizes.  Depending on the size, a subtle or a dramatic result can be accomplished.  If you feel that your chin is not large enough, it can be very easy to exchange it for a larger implant.  There are 2 issues that can make it more difficult to exchange the implant:1)  The implant is secured with a screw2)  The implant is not silicone.  Silicone implants are easy to remove while Gortex and other material are more difficult.I hope this helps.

Paul S. Nassif, MD · Answer

A chin implant generally leads to a noticeable difference following placement, but this depends on the size of the implant used and what is discussed with your surgeon ahead of time. It is important to establish good communication with your surgeon prior to having a procedure performed. I would recommend communicating any concerns with your surgeon, as he/she knows the details of your procedure. I hope this helps, and I wish you the best of luck.

Barry L. Eppley, MD, DMD · Answer

It is clear at this point after surgery that your result is not as big as you had desired. This is either a result of too small an implant being placed or that the sizes of available preformed chin implants are not big enough for your needs. It would be helpful to know exactly what implant style and size you received. That will determine whether any available larger chin implant size will work or whether a custom designed one is needed. There is no increased risk for exchanging to a new chin implant than their was with the original surgery.

Majid Jamali, DMD · Answer

Most likely your surgeon placed the implant that fits your profile. It is not a good idea to place a large implant in a person who has a small jaw. This might create problems for the underlying bone. Also, the shape of the chin wouldn't look good.

Frederic H. Corbin, MD (license restricted) · Answer

I generally take photos of the patient and alter them digitally to determine what size the patient wants "subtle vs more obvious change"  That way going into surgery there are no confusions.  I also bring sizers into the room with the patient to let them see the difference prior to surgeryDr. Corbin

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

Chin implants are for an under projected chin.  The size and outcome will typically be discussed in depth prior to surgery.  Without photos of you, it is hard to know exactly what you needed and what was placed.  No, it is not normally a problem to increase the size of the implant, but we would need to see photos.

Is a chin implant only supposed to create a subtle difference?

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