Silicon chin implanted 20 years ago causing bone erosion: What should I do? (Photo)

The implant is not in the optimal position.  It is high, which is a more commonly seen with the intraoral insertion versus an external skin incision. should be lower, at the bottom of your chin.  Now it is pressing near the tooth roots which is not good.  A sliding genioplasty (osteotomy with sliding of the chin forward and plating it in place) is a great way to augment the chin.  It is fairly straightforward in experienced hands.  Of course, a plastic surgeon, oral surgeon or maxillofacial surgeon should be the one to help you decide between a sliding genioplasty versus another implant after an in person consultation.  Best wishes. 

I think the simplest and safest procedure would be to remove the current implant which is too high and replace it from below. The external placement from below allows it to be secured and placed flush with the lower edge of the mandible.Good Luck

It needs to come out.  I would do a synthetic bone graft at the same time and not put anything back for 6 months.  You could put another chin implant, but it needs to be fixated to the bone wiht screws as it is the micromovement that produces this type of erosion.Joe Niamtu, III DMDCosmetic Facial SurgeryRichmond, Virginia

This is classic chin implant settling, not a true inflammatory erosive process. It is most commonly seen from the intra-oral placement of chin implants where the implant has been positioned too high over the thinner cortex of bone near the tooth roots. It is probably a process that is stable and further settling into the bone is unlikely from where it is now. Unless you are having tooth sensitivity, there is no urgency for removing it. If you do remove it, it can be simultaneously replaced with either a sliding genioplasty or a new implant secured in a lower better position with screw fixation. If a sliding genioplasty is chosen then it can be done intra-orally. (with a better incision location than the one you have now) If an implant replacement is chosen then it can be done from a submental incision on the underside of the chin. There is no reason to have separate surgeries for removal and any form of new chin augmentation. Given the size of the bone defect, it can be filled in with demineralized bone paste or granules to restore some bone thickness.

Only in person evaluations allow a determination if the aggressive bony work is needed. Good luck.///