Is there a way to have a chin implant with extended sides to fill in and smooth out the jawline without causing bone loss?

Question

I had a small chin implant replaced with a bigger one about 8 years ago and the surgeon told me I had bone loss because of the extended "wings" of the implant. Now with the new one, I have to keep getting Radiesse injections every year to fill out depressions on each side of my chin and make my jawline smooth and attractive. Can I safely avoid injections with a new extended chin implant? Or is bone loss still likely? Also, what's the expected recovery time for any procedures? Thanks!

Jonathan Kulbersh, MD · Answer

You shouldn’t have bone loss with a chin implant, nor should you need fillers to smooth out depressions. It sounds like you were not fitted properly. Spend some time interviewing the most expert facial plastic surgeons in your area to find one who gets consistently great results with chin implants. Once you find this expert, you’ll get all of the other answers to your questions, too. I hope this helps.

Michael P. Morrissette, DDS, FACS · Answer

There are several treatment options. If you elect to replace the implant with another implant then I would recommend a custom implant design that is created from a 3 -D CT scan. A genioplasty is another viable consideration because your own chin can be moved forward up to 9-10 mm. A genioplasty can add height as well if that is necessary. Both procedures can be performed in the office with IV sedation and require 4-7 days recovery depending on age of the patient.

Philip Solomon, MD, FRCS · Answer

Thank you for sending your question.  An extended anatomic implant is the commonest implant used in my practice.  This implant provides a natural transition as the implant extends laterally.    Bone loss while common is not often clinically significant.   See a surgeon who performs chin implants frequently and review product designs from the implant catalog.   Together you can pick the implant that will give you the best chance of obtaining the look you are hoping for.   Good luck with our procedure.

Jayanthy Ravindran, MS, DNB, MRCS · Answer

Hey there,Following chin implants partly because of the pressure exerted over the mandibular bone. When correctly positioned bony erosions can be minimized. Placing an implant higher up over the alveolar bone can lead to erosions more often. Newer implants with extensions and properly selected implants have reduced erosion risks. If there are contour deformities fat injections or fillers can be used. following implants, the recovery time could be between 3-5 days. Swelling is more in the first 48 hours which gradually subsides over a period of one to two weeks’ time.
  Hope this helps.

Jeffrey Jumaily, MD · Answer

I don't know that bone loss from the wings of a chin implant is ever noticeable. If you would like to fill in the prejowl areas (sides of the chin) without using fillers then another implant may be necessary. I recommend a consultation for more detailed exam and discussion. Best wishes

William Portuese, MD · Answer

A full set of facial photographs and usually an in-person examination going to be required to make a determination about how to proceed. Removal of the smaller implant and placement of a larger implant with  extended wings may be of some benefit. There is not bone loss that occurs with the implant,  it is bone remodeling, since bone is living tissue

Barry L. Eppley, MD, DMD · Answer

Chin implants do not cause bone loss per se. There is almost always some degree of implant settling into the bone, a natural and benign self-limiting biologic phenomenon, that is often erroneously referred to as 'bone loss'. This occurs centrally over the main body of the implant but rarely extends out onto the wings of the implant where the material is the thinnest and exerts the least pressure on the bone. An extended chin implant will help fill in the prejowl areas. Whether this can be satisfactorily achieved with a standard style implant or requires a custom approach depends on how far back along the jawline the augmentation needs to go.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Bone loss is caused by pressure of the implant on the bone. If you don't go too big with your implant projection you should not cause too much pressure on you bone. Just having lateral extensions does not create increased pressure on your chin bone. Again, it is the size of implant not the shape that will cause increased pressure on the bone. A chin sizing is recommended so that you can see the exact chin implant style will best fit your needs.

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your problem but an exami is really needed as what you are describing is unusual.  So go on some complimentary consultations with experts and be evaluated and compare recommendations and become fully informed about what the problem is and how it might be corrected Dr Corbin

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.  Non smiling photos of your face from the front and side along with some information on the current chin implant (material, manufacturer, model number which defines shape and thickness = projection).   In my experience and bone erosion is typically over the front of the chin and not along the sides where the implant tapers.  I prefer using extended anatomical (EAC) silastic chin implants placed through a small, curved incision under the chi as described below.  In my humble opinion these provide the most natural chin augmentation.  It might be a good idea for you to have a 3-D facial scan that would show the facial skeleton in 3-D as well as where the existing implant is located and its shape. 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.  
Hope this helps.

Is there a way to have a chin implant with extended sides to fill in and smooth out the jawline without causing bone loss?

Answers (12)

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