Removal of implant and Fat grafting to chin?

Its 3 months post op. Nt happy with wings chin impant. All i wanted is just projection. Now my chin looks very huge, lengthy, and elevated. So requested the surgeon to remove it and get the fat grafting done later. Bt he said he wil graft the fat immediately after removal of the implant. Is it possible?? Is it safe? I got fat to my lips, he did a gud job. Bt i m nt confident abt this procedure.

Doctor Answers 2

Removal of implant and Fat grafting to chin?

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The best way to augment the chin is typically by bone advancement or with placement of a solid implant material (which appears to be what you had). This is true because the majority of the chin is bony and it is necessary to provide a solid augmentation that will assist the lip muscle function and yet also firmly support the chin tissues to prevent drooping over time. Chin implants come in pre-made sizes, and quite often, especially in women, the chin implants can be too wide for a patient who needs significant projection. For this reason, different types of implant shapes are available. I have learned that the typical large chin implant (extended anatomical type) is too wide for most women; as a result, I often use a medium extended implant and add an additional implant termed a Glasgow wafer to add a few more milimeters of projection without widening the chin. An alternative maneuver would be to simply carve the implant (yes, this can and is often done) to make it narrower and contour to your chin shape better. I would be much more likely to recommend that the chin implant be removed and carved or replaced by a better implant design than proceeding with fat grafting. Fat grafting is itself fraught with issues, such as a typical 50% loss of volume over the first year. In addition, placing the fat into the implant pocket may create additional issues as the fat would be positioned in between bone and capsular tissue, both of which may be less than ideal to provide the fat with the blood supply it needs to survive. Finally, augmenting the chin with fat would make it larger but not stronger, and over time it may droop, creating a "witch's chin" deformity, which you may already be at risk for given that you have already undergone chin augmentation. Please discuss all of these factors and treatment options thoroughly with your surgeon before deciding on which therapy is best for you. Best of luck.

Clermont Facial Plastic Surgeon
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Chin implant removal

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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. 

Most important of all make sure you pick a plastic surgeon with great expertise in #chinaugmentation and #chinimplantremoval. 

See the below link on how best to choose your surgeon.

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.