Prone to Keloid Scars, Got Them from Breast Augmentation. Can I Do A Chin Implant with an External Incision - Yes or No?

I am a 22 year old italian female. I have previously had a breast augmentation and it has left me with a hypertrophic scar on the left breast and a keloid on the right breast. (I know the difference between hypertrophic and keloid). I am now considering a chin implant but a lot of surgeons I have found will not do the incision inside the mouth in case of nerve damage (which evidentally is what happened with my breast enlargement). Should I risk an external incision or forget about it? Thanks

Doctor Answers 4

Especially with risk of keloid scarring, external incision is safest, best choice for chin implant

I believe the external approach is a much safer and more precise approach for any chin implant surgery. Particularly in your case, if the incision were placed inter-orally, a hypertrophic or keloid scar would be much more difficult to manage in this location.


With your known history of poor scarring, the safety of using an external approach is even more convincing. Since you know that you've had scarring difficulty in the past, precautions should be taken to ensure the cleanest, most precise scar possible.

Such precautions available to reduce your chance of keloid scarring include:

  • pre-emptive steroid injections
  • post-operative scar gel
  • placement of surgical tape in the scar area during the early stages of healing, to prevent hypertrophic scarring from occurring with this new incision.


Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Keloid Secondary to External Incision for Chin Implant

Unfavorable scars are much more common with incisions in the breast. It is very unlikely that an incision under the chin will cause a keloid or hypertrophic scar. Have you had any previous facial cuts or ear piercing for ear rings which would provide insight to how your facial incisions will heal?

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Chin implant

Because of having a darker skin and also forming keloid and hypertrphic scar, you defenitely are more prone to have unsightly scar in any part of your body. However, I have not seen any keloid or hypertrpphic scar after chin implant with external approach. There is always possibilty of some numbness of the lower lip after chin implant whether it is done internally or through external incision. If the procedure is done by an experienced surgeon the chances of injury to the sensory nerves are significantly less than formation of keloid scar, at least in my own experience.

Fereydoon S. Mahjouri, MD
Minneapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews

Chin implant , chance of keloid

In the period between 1960 and 1990 many chin implants were inserted with an intraoral incision. However, they were of the central augmentation design. They did not extend as far laterally as most presently designed chin impllants. They were easy to insert and had less chance of causing sensory nerve damage. If a central augmentation is suitable for you , this could be considered. 

If you do not form keloids of the head and neck, you may be at low risk if having a keloid under the chin. If you have had your ears pierced without problems, a submental scar is less likely to keloid than otherwise.      

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

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.