Removing silicone chin implant after 1 year, what are the consequences?

Question

Hello, I had a silicone winged chin implant placed July 2016, it was 8 mm. The implant was not fixed and it is movable, as in I can move it up and down by pushing it (but not left and right). It does not feel like a real chin at all. As it is not fixed, instead of projecting forwards it is pointing downwards due to gravity. I want it removed. Will my chin go back to the way it was before, and will my face skin sag after removal? Your expertise is greatly appreciated. Thank you.

Michael I. Echavez, MD · Answer

Removal of a silicone chin implant is normally a fairly simple procedure.  After the surgery, I find in most cases, the chin does return to how it looked like before the implant was placed.  It is possible that there may be some scar tissue which could produce a small amount of augmentation, but usually there is not a problem.  I have not found sagging skin to occur.

Zoran Potparic, MD · Answer

Several factors may influence chin appearance after chin implant removal. Size of implant and pocket where implant is placed will determine how stretched your soft tissue is and whether soft tissue will sufficiently retract after implant removal? Nobody can exactly predict it. It is possible that tissue sagging (ptosis) may be observed after removal? You should consider replacement with more stable implant that can be fixed to the bone, or slightly smaller implant placed in a new pocket. In-person evaluation and discussion about options with a board certified plastic surgeon with significant expertise in facial implant should be your next step. Good luck.

Marcelo Antunes, MD, FACS · Answer

Thabk you for your question.
Generally speaking, chin implant removal is a simple procedure.  The chin should return to the position that it was before the implant was placed.  It is possible that there may be a capsule around the implant and scar tissue which could produce a small amount of augmentation, but, even if present, typically is very minor and unlikely to be a problem.  I would not expect any sagging of the chin skin to happen. Good luck

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  I use silastic extended anatomical chin implants most often in size small and large (5mm, 6mm projection).  The ones with 8 mm's projection are extra large (XL) which can be difficult to stabilize.  You may want to ask your Chin Implant Surgeon if your implant was placed above or below the periosteum.  Above allows the implant to be moved (especially up and down) as it's in the tissues and not held in place by the tough periosteum layer.  While you can send non smiling photos of your face from the front and side as well as the same views pre-op, the existing implant can be removed through a small, curved incision under the chin.  At the same time you can choose to have a small or medium (small typically for women) EAC silastic implant placed under the periosteum or have an off the shelf dermal filler to augment the chin.  If you had some degree of chin ptosis (sagging mentalis muscle), the chin muscle will sag if the implant is removed and another (smaller) one isn't placed.  If you had no chin ptosis pre-op even the XL implant for a year should not create sagging tissues in the chin once removed. When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.    
Hope this helps.

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