Can a Silicone Chin Implant Be Secured with Screws?

Question

i have decided to have a chin implant. the issue for me is that i am a boxer, and realistically, i am not going to stop boxing afterwards so it would make sense for me to have my chin implant screwed into place. will this be ok? i have spoken to a plastic surgeon who specialises in facial surgery and he informed me that he only uses silicone implants and that its not possible to screw them in place. can someone elaborate on this, and what they would recommend? i'd prefer to not use medpor.

Eric M. Joseph, MD · Answer

I read your concern. Frankly, if you're going to continue to box, you should consider holding off on chin implant surgery. A blow to your chin after surgery may increase your risk of developing an infection, no matter how it's fixated.

	In my practice, chin implants are typically secured to the lower jaw periosteum with two 5-0 PDS sutures. Careful elevation of your implant's pocket, along with these sutures, prevents shifting of your implant while you're healing.

	Hope this helps you.

	Dr. Joseph

Larry S. Nichter, MD, MS, FACS · Answer

The pocket is usually made under a thin but strong membrane called the periosteum with the pocket made to the exact size. The pocket then shrinks down around the implant to hold if firmly in place and it will feel just like your chin - you will not be able to wiggle it. I do not recommend screwing in a chin implant as theoretically the screw might serve to weaken your bone and increase the chance of fracture with a direct blow.A a screw is not usually used for silicone implants (the most common type) but is used for others such as PTFE, Gortex, Medpor, etc.

S. Larry Schlesinger, MD, FACS · Answer

The force generated by a hook or an upper cut, or for that matter a straight jab, will displace a chin implant whether it is anchored with a screw or not.  For that matter, if one engages in MMA, being choked out can also lead to implant displacement. 

	The reason I know the above is that I have several patients who routinely engage in various forms of martial arts.  I have had implants displaced that were not anchored down.  My second stage procedures on these individuals led me to put in titanium screws, one and sometimes two, through the silicone implants into the anterior mandible.  I learned through bitter experience "don't put chin implants in people who actively train or participate in mixed martial arts".  It's a losing proposition.

Gregory T. Lynam, MD · Answer

A screw is not needed for a silicone implant. After 2 months the implant should be stable but certainly a direct punch may dislodge it but I have not seen this reported in the medical literature. Good Luck.

Stephen Weber MD, FACS · Answer

Yes, a silicone implant can be secured with screws though I never recommend this. No chin implant can be truly secured considering that you are a boxer. The screws tend to be very delicate. Thus, one direct punch to your chin will likely dislodge the screws and possibly the implant. I don't think screw fixation will result in a safer chin implant for you. I hope this information is helpful.Stephen Weber MD, FACS

Can a Silicone Chin Implant Be Secured with Screws?

Answers (10)