How Does a Surgeon Check for Capsular Contraction in a Chin Implant?

Question

After 18 years (im 37) the scar tissue may have hardened. It feels different, tighter and less pliable, with the occassional ache. Also, if I decide to have it taken out, could I leave in the scar tissue, and would it augment the original receded chin? Are there any complications I should know about? It is a small silicone implant. Many thanks

Andrew P. Trussler, MD · Answer

Chin implants can be made of multiple different substances including silicone, porous polyethylene, and gore-tex. They can usually don't have the same propensity for scar formation as a breast implant because of the solid nature of the implant, though softer implants with liquid silicone have been available. That being said, scar formation can occur around the implant, as well as boney erosion of the chin(mandible). If there is a change in the chin consistency, and your implant is 18 years old, you should consider at least an evaluation with a plastic surgeon and possible imaging of the mandible with an x-ray and CT scan to determine the condition of the bone under the implant. Removing scar in this area can lead to injury to nerves and muscle in this area, so it depends on the implant pocket condition and need for soft tissue augmentation after the implant is removed. Placing another implant at the time of the removal may be an option, as well as changing to a solid porous material as well. Biostimulators such as Sculptra, as well as fillers like Juvederm and Radiesse may also be a nice transition from needing an implant replaced. Fat grafting could also be considered. If there is a need for more augmentation and an implant is not an option to replace back in the pocket secondary to scar you could consider an osseous genioplasty. 

	I hope this helps.

	Dr. Trussler

Richard W. Fleming, MD (retired) · Answer

Capsular contracture is not an issue with a small silicone chin implant because the graft is solid. After 18 years there could be some mandibular bone erosion behind the implant. A CAT scan might be helpful if you have noticed some changes. If the implant is removed you may have some residual chin augmentation secondary to the scar tissue. The implant can be replaced - implant designs are better than they were 18 years ago.

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