How can I fix my swollen chin? (Photo)

Question

I had a chin implant in august 2020, in october 2021 i had the implant removed and did a sliding genioplasty. 7 months after the procedure my chin is still swollen and i hate the look of it, the doctor told me that my muscle is swollen from the implant and my only option now is botox. Is this a swollen muscle or skin tissue ? What should i do since i can't live like this and botox isn't helping ? Help please

Timothy Osborn, MD · Answer

It is not uncommon to have an implant removed and a genioplasty with some residual soft tissue problems. It is a big part of why we mostly do genioplasty outside of a few indications. A lot of what you are seeing is the soft tissue problem at the junction from jawline to chin. When you put the implant in (presuming silicone but happens with medpor too), you get a capsule all around it. When you remove it, the implant typically goes further back than where you would make your cut for a genioplasty. So part of what you see in your first pic is scarring at the back of the capsule. From what I see, you should have had your chin go further forward. If I am mistaking it based on your pics and your first pic is the implant, last one is after genio, but regardless, your chin should be further forward. Looks like only a 4-6mm advancement of the chin segment if I am seeing your x-ray correctly, and your lip is undersupported. My recommendation would be to do a genioplasty with 8-10mm of advancement so your chin goes up just a bit and becomes more defined. This would remove that little deflection down at the junction of jawline/chin.  Your chin should project to just behind your lower lip, and with how flared your lower front teeth are, you need to get the chin segment further forward to provide that improved support. I know it is hard to look at more surgery, but would be the best option from what I can see.

Darryl J. Blinski, MD · Answer

The posted photo really help see your chin implant issues. I would first try any method that is non surgical - like multiple diluted BOTOX injections to try to shrink the tissue/muscle. Might also inject hyper diluted KyBella to melt any fat areas. If this does not achieve a satisfactory result then removal of implant/ exchange to smaller implant/ or injection of long lasting HA fillers or fat grafting. Best to seek virtual consult with....

Mats Hagstrom, MD (license on probation) · Answer

This is the result of the procedure.
Part of the appearance comes from the fact that your entire mandible is small and an ideal look would come from simply having a bigger mandable. Extending just the chin is not the same as having a bigger mandable. A bigger mandible would’ve moved your lower dentition and aligned your teeth better and your lips better. The sliding genioplasty makes the relationship between your lower lip and chin worse making the chin look big.
A jaw advancement may have been a better procedure but is an operation most people are not willing to undergo.
Your results are final at seven months. Your muscles are not swollen.
Chin augmentation advances the chin but worsens the relationship between the chin and the lower lip and those who already have some projection of the chin on a mandible that is overall undersized.
Best,
Mats Hagstrom MD

How can I fix my swollen chin? (Photo)

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