Mental nerve compression 20 months after implant - should I proceed with removal?

Question

Hello, I had a large chin implant completed with no issues. About 20 months later all of a sudden I started noticing loss of sensation, pins and needles and all the signs of compression on the lower right part of my chin near jaw line. I waited about 6 weeks and saw small improvement in sensation but I still made an appt with a different surgeon ( I didn’t like the surgeon I had originally ). I am positive there was no hard impact to the chin. The surgeon next availability was 9 weeks later but since then I’ve noticed the sensiatiom has improved and we are now 13 weeks since I noticed. The healing doesn’t seem to be linear because some days I only feel it a little and some I feel it more, which adds to my confusion. I failed to mention above that I did see the other surgeon and the 9 week availability lead time was for the removal procedure not the office diagnosis visit. So now here we are only 3 weeks until removal procedure and my question Should I stick with removal or postpone to see if healing continues?

Furkan Erol Karabekmez, MD - Account Suspended · Answer

Hello,What you describe does sound consistent with irritation or compression of the mental nerve, but the fact that your sensation has been gradually improving over the last 13 weeks is an encouraging sign. In many nerve compression cases, improvement can be slow and not perfectly linear &mdash; some days feel better, some worse &mdash; while the nerve recovers. Sensory recovery after mandibular nerve irritation often takes weeks to months, and longer recovery windows are well described in the literature.
For that reason, I would usually be cautious about rushing into removal if symptoms are clearly trending in the right direction. At the same time, I would not base the decision only on symptoms. The key question is why this started 20 months after surgery. A delayed onset of numbness or tingling deserves a careful evaluation to look for implant malposition, shifting, scar-related compression, or another local cause. Imaging and a proper in-person examination are very important before deciding on surgery. Studies on mandibular implant-related nerve disturbance emphasize that radiologic evaluation is a central part of decision-making.
So my general advice would be this: if you are continuing to improve, it is reasonable to discuss postponing removal and reassessing with your surgeon, especially if the diagnosis has not been fully clarified. If imaging or examination suggests that the implant is actually compressing the nerve, then removing the cause may be beneficial; when a true mechanical cause exists, eliminating that source can help recovery.
In short, improvement argues for caution, not panic. I would want a clear diagnosis before proceeding, and if recovery is ongoing, a short delay for reassessment may be more sensible than automatic removal.
Best wishes.

Mental nerve compression 20 months after implant - should I proceed with removal?

Answers (1)

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