What Do I Do if I Have a Pinched Nerve After a Chin Implant?

Complications and side effects are very uncommon but possible with chin augmentation. However, there is a small degree of risk. The most likely side effect is altered sensation in the chin and lower jaw, which may be temporary or permanent depending on the extent of the surgery and lower lip weakness. A board certified plastic surgeon will be able to tell you if you are at particular risk for this type of side effect at time of consultation. In your particular case the longer the numbness the less likely it will resolve especially after a year. Routine Xrays are not helpful to diagnose a nerve injury

The first advice I would give is that you return immediately to your operating Surgeon and discuss your situation.  As other Surgeons have stated on this topic, the lack of sensation at 7 months is concerning.  However, sensory nerves can take 12 months to recover if stretched or injured (axonotmesis).  Alternatively, if the edge of the implant is resting on the mental nerve, removal of the implant may lead to a recovery of sensation.  An x ray will not help, seeing your Surgeon may.

Is your numbness complete or partial?  Is it improving?  If the numbness is partial and improving and you are otherwise pleased with the implant, I would suggest leaving it alone.

If the numbness is complete you either suffered a severe injury to the nerve at surgery or the nerve is pinched.  Time is running out to help a pinched nerve and you have a decision to make.  Do you just live with the numbness, or do you remove the implant and hope the nerve recovers?  If you are serious about giving yourself the best chance for nerve recovery, the implant should be removed, not repositioned.  You can always have the implant reinserted 6 to 12 months after removal being careful to stay well away from the nerve on the second try.

I have to say, I am quite surprised by all of the mental nerve troubles I see on this website.  Chin implants should be placed along the very bottom edge of the jaw bone a safe distance from the nerve.  Whether the implant is placed through the mouth or through the underside of the chin, I keep the pocket for the implant completely separated from the nerve.

The nerve ( mental nerve )  is lateral to the chin. It can be injured during the surgery or the implant may cause pressure on the nerve and cause the nubness. If this numbness continues more than 6 weeks then  x-ray or CT scan can give an idea as to where the implant in relation to the nerve. The implant should be removed if there is evidence that it is the cause of pressure on the nerve, hopefuly the nerve function will come back.

Consult your plastic surgeon

Seek immediate (but you might be too late) opinions from maxillo facial boarded surgeons. Seven months this could be an indication of permanent damage. 

The mental nerve is at risk of injury with placement of a chin implant.  It can be stretched, injured with cautery, traumatized with a stitch or cut.  Depending on the injury, recovery can be from several days to several months.  At 7 months, the chance of spontaneous recovery is small.  There is likely no benefit to any type of imaging study. 

The Mental nerves, which come out of the jaw close to the front of the jaw and supply sensation to the lower lip, may be damaged with any surgery involving the lower jaw - this includes oral surgery and cosmetic surgery. Most commonly the nerve is stretch damaged. However, depending on the amount of stretch many injuries heal at about 1mm a day with resumption of sensation before 6 months. At 7 months we must assume that you had much more serious damage.

Question - WHY aren't you involved with either of your chin implant surgeon(s)? After all he/they were there and may know best what took place. A simple X-ray will not show nerve damage. You may require a MRI which may or may not suggest what took place.

Peter A Aldea, MD