I want a chin implant, but I'm also terrified of bone erosion. Would x-rays be an option to control the implant?

Question

Im tired of having HA fillers so often to keep the result im looking for. I want a permanent solution to my short chin, and genioplasty is no option. But im terrified of getting bone loss as a result of an implant. What if i get bone erosion and have to get it removed, there would be nothing left of my (already before the implant) short chin. If i take x-rays of the chin every year would i be able to notice a possible bone erosion early? And get if removed before it makes a visible damage?

Jonathan Kulbersh, MD · Answer

There isn't a significant risk of bone erosion. A chin implant can create a stronger profile and improve vertical length. When well placed by an expert, a chin implant can last for decades or a lifetime. You can choose a chin with will give you a better projection and smooth the jawline. Liposuction can further define the jawline. A consultation with a board-certified facial plastic surgeon is important; for the patient to be evaluated, their goals discussed, and a custom treatment plan decided upon. I hope this helps.

A. Joshua Zimm, MD · Answer

Your concern is a theoretical one that has no real clinical significance.  With good surgical technique, the implant is placed with a layer of tissue between the implant and the bone.  It’s a non-issue that you should not be concerned with in the least in making this decision.  Best wishes.

Sam Lam, MD, FACS, FISHRS · Answer

A chin implant placed in the right position should not cause significant bone erosion.  It is important to place the chin implant over the bottom portion along the mandibular cortex that is very thick that supports a chin implant.  I remember a guy that came to me for a revision chin implant and he had the chin implant placed so high that it was eroding into his dental roots because the bone there is thin and does not tolerate an implant.  The encapsulation that goes around the implant can somewhat compensate for the bone erosion if there should be any but obviously there cannot be a guarantee of a 1:1.  You really should not need your chin implant ever removed so this should not be an issue.  Looking at my patients over the years, they really maintain their position.  That is why I use only silicone implants.  Gore-Tex implants flatten over time and Med-Por can also do the same not to mention the infection risk and the impossibility of removing them.  Hope this answer helps.

Barry L. Eppley, MD, DMD · Answer

Some passive bone remodeling under/around a chin implant can occur but this is a benign process that has no adverse effects. The concept of 'bone erosion' implies some active inflammatory process that is destructive and is inappropriately used for this common phenomenon. Passive bone remodeling is normal around many implants throughout the body and should not be of concern in chin implants.

William Portuese, MD · Answer

When removing old chin implants, we notice bone remodeling, not erosion. Bone is living tissue and remodels around an implant. This is only an incidental finding. The bone in the mandible in that location underneath the chin implant is  usually approximately a half an inch thick, and we've never seen a real problem with bone erosion in 26 years performing chin implants.

J. Marshall Green, III, DDS · Answer

Hello, 
    Thank you so much for your question! I can tell you’ve been doing your homework. Posterior position of your chin and/or jaw may classified by several terms: gonial or mandibular hypoplasia, micrognathism, microgenia, etc.  I really enjoy placing facial implants and they can create an amazing and immediate change for my patients. With all the information available these days your question is a common one that I hear. The answer is a simple one however. Implant fixation is crucial to avoid bone loss in mandibular implants. The best way I have found to do this is with a small single screw. Since going to this technique which only takes a few extra minutes in surgery, I have not seen bone resorption in chin implants. I would encourage you to find a surgeon that uses fixation techniques. Should you still be concerened surveillance X-rays can still be taken every few years. I am very fortunate to have CT scan device for the head and neck in my office and this is what we would use!
Once you decide what you want then you need to look at who will do it!  When it comes to deciding on treatment my best recommendations are to meet your prospective surgeon, check out their facility, review their photo galleries either in the office or online and lastly if you feel the need speak to their prior patients. I always have patients willing to tell prospective patients about their experience in my care. I hope that helps and best wishes on your upcoming proceedures!
Dr G

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  I do perform chin augmentation using dermal fillers so I can appreciate the feeling that you're tired of having repeated dermal fillers to augment your weak chin.  The simple fact is that a silastic chin implant is far more cost effective over the years that repeated dermal fillers.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  In my experience the degree and occurrence of true "bone erosion" following chin augmentation with a silastic chin implant is quite rare.  Far more common is some bone stimulation of the bone underneath the chin implant which has no effect on the bone or the aesthetic result.  X-rays are a tool to evaluate bone erosion but will not stop or have any effect on the bone whatsoever. 
Hope this helps.

I want a chin implant, but I'm also terrified of bone erosion. Would x-rays be an option to control the implant?

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Answers (7)

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