i had chin implant in 2008. it has always been crooked. i had prior asymetry to my face but i believe it is far worse now. my doctor says he can fix it but that my faces asymetry makes it difficult. im fine with my improved profile. its from the front that it looks bad. my surgeon wants to take the implant out, wait 8 weeks, then reinsert it. im worried about how it will look with the implant removed. will there be sagging skin? will it look like pre-surgery? ive included before and after pics.
Does Plan Sound Right? Should I Trust Him or Go to Another Surgeon? Do I Need a Custom Implant Due to Bone Structure Asymetry?
Doctor Answers 5
Preoperative 3D CT Scan Analysis and Custom Chin Implant
There is no obvious reason why this would need to be a two-staged procedure. There is no benefit to simply removing the implant and allowing it to heal...unless one is trying to figure out what the chin looked like before the original procedure. But that could be better determined before surgery with a 3D CT scan that would look at your chin/mandible anatomy, show what the existing implant looks like and where it is on the bone, and then digitally remove the implant and look at the natural shape of the bony chin. From that a custom chin/jawline implant could be made which is the best approach to avoid a different chin asymmetry problem after a new 'eye-balled' chin implant is inserted. It is impossible to beat what computer-designing an implant can do in cases of facial asymmetry.
Remove and Replace Chin Implant
The asymmetrical implant can be removed and replaced during the same operation. The size and shape of the new implant will be determined preoperatively after physical examination and can be contoured during the operation.
Tapered chin; poorly placed implant
Before surgery, you had a 'narrow' tapered chin and side of jawline. Any profile enhancement has to consider the 'para' chin/side of chin area in order to provide a continuous jawline look/esthetic. The implant can be removed and a 'new one' along with implant strips in the 'para'/side of chin area inserted; all at one sitting to minimize scarring and adhesions/ which could cause the lip to 'droop a bit' due to loss of mentalis muscle; and also dimpling can occur after multiple surgeries.
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Chin Implant Replacement
Thank you for the question and your pictures. I agree, the implant looks crooked. While you certainly had some asymmetry pre-op, this has persisted post-op. Chin implants come in a variety of shapes and sizes. In addition, silastic implants can be trimmed or shaved by the surgery at the time of the procedure. Finally, there are "add on" silastic pieces that can be used to compensate for asymmetry on one side, bone loss, etc. These are typically placed behind the implant, the give a smooth outer profile. As far as replacement goes, unless your old implant is actively infected, there is no reason to wait to put in a new implant.
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Chin implant problems
I would recommend a genioplasty. This could help correct the asymmetry as well as the projection. Could be done at time of implant removal. Donald R. Nunn MD Atlanta Plastic Surgeon.