Has the size of my chin implant ruined my smile? If I get it removed, will my smile return to normal? (Photos)

Question

I had a silicone chin implant inserted in 2015. 4 years later, I am still unhappy with it. I feel it is to big for face and since I have had it, my smile has been ruined. My bottom lip now stays flat when I smile instead of making. "U" shape like it used to. I refuse to smile much anymore and I have suffered depression because of it. It still feels really tight and looks too big. Is it the physical size that's preventing my bottom from making a "U" shape or could it be nerve damage?

Michael P. Morrissette, DDS, FACS · Answer

I would like to know the position of the chin implant to give you advice. Malposition of a chin implant is a common problem. A CT scan of the chin would be helpful. In general, when a chin implant is removed, the soft tissue and chin return to their previous appearance. You might consider removing the implant and having a genioplasty procedure to maintain the appearance of a strong and masculine chin. This can be accomplished simultaneously.

Barry L. Eppley, MD, DMD · Answer

Your assumption about implant size is the most logical one for your elevated lower lip position. A chin implant is a space occupying mass for which the surrounding tissues became somewhat displaced as a  result. While most of this effect is in increased horizontal projection it can also cause upward tissue movements based on size of the implant and the implant's position in the bone. The best way to determine whether implant position and size could be the source is a 3D CT scan of the chin. From which it can be decided whether complete implant removal or reduction in size of the implant would be the best approach. I doubt this is due to any facial nerves issues as the lip elevation is central and not just to the side of the lower lip on one side or the other. This appears as a straightforward mass effect.

Mats Hagstrom, MD (license on probation) · Answer

My best guess is that removing the chin implant or downsizing to a smaller one will not change your smile at this point. It happens from time to time that a branch of the facial nerve may get a little stretched and potentially damaged from this procedure. Generally function returns within a few months and sometimes up to a year. Most of the time it’s seen more on one side than the other. Your situation is a little bit unique in that it’s on both sides and has persisted for several years. Downsizing and implant or removing one is far easier than the initial operation. He can probably be done with local anesthesia in the office. I have certainly removed implants in the office without difficulty.Time will tell if you move forward with the procedure but my best guess is that your smile will not return to pre-procedure. I hope I’m wrong and looking forward to hear what other providers may have to say about this.Best, Mats Hagstrom MD

Has the size of my chin implant ruined my smile? If I get it removed, will my smile return to normal? (Photos)

Answers (3)