What is wrong with my chin implant? I really dislike the downward projection. (photo)

Question

Hello, I had a chin implant inserted about 13 months ago. The doctor recommended a large size and so I had an 8 mm silicone winged implant. I have been able to 'wiggle' the implant up and down since ever and since it is unscrewed the implant seems to be pulled by gravity downwards especially when I look up. What causes this and is it common?  Also, from the front it looks very boxy and masculine. How can I improve on this and get a feminine result?

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

Chin Implant removal information/and considerations: For the vast majority of chin implants, removal is straight  forward most commonly using the  same incision that was used to place it. The procedure is often done in the office with local anesthesia with or without some sedation, but also commonly done in the OR under IV sedation or general anesthesia per patient's and surgeon's preference.  Most implants are silicone and are not adherent so slip out readily. Medpor, also called PTFE, may have tissue ingrowth and can be a bit more involved but still can be removed in the same manner.  It is very helpful for your surgeon to  review your prior surgical records to know the size and type of implant used. This may be obtained by contacting your prior surgeon's office or OR facility and request your prior surgical records.
Expectations: if the chin implant was small and removed within the first few years chances are likely that you will return a similar size and shape as before. If the implant was small, the chin soft tissue usually shrinks back down without  sagging.  Often, there is still some gain once the implant is removed due to the scarring and capsule (lining your body makes around the implant) that gives some benefit. On the other hand a large implant placed many years ago, and other factors such as being elderly, having osteoporosis and perhaps smoking that can cause loss of underlying bone due to  bony erosion from the pressure of the implant. In this case  use of a natural filler such your fat or at times a bone graft may recommended for different reasons. Your surgeon may request a  Panorex or lateral cephalometric x-ray to see if this is the case.  Temporary fillers can also be tried such as Jeuvederm, Sculptra, Voluma, Volbella, etc. 
Most important of all make sure you pick a plastic surgeon with great expertise in #chinaugmentation and #chinimplantremoval.

Robert J. Troell, MD, FACS - Account Suspended · Answer

Good day. Thank you for your question, narrative and photograph.If you liked the aesthetic appearance with your symptoms, no treatment is an option. The symptom of lower mandible placement and mobility suggests the implant may be placed too low on the mandible. An Xray or CT scan can assist defining this.Being a young woman, this size silastic implant is large. However, your lateral photograph does show satisfactory anterior projection, meaning it does not look too large.However, the anterior view does show a low position in the midline, too much fullness adjacent to the midline (paramedian area) with more lateral volume deficiency.Reviewing your photographs with you to confirm your desires and the chin appearance is imperative to determine the next step for revision.Solution: Remove implant, place the implant higher on the mandible in the midline, trim the inferior paramedian aspect of the chin implant (usually needed in women to prevent the masculine appearance, and most likely not done on your implant), and consider volume replacement laterally in the form of a filler, radiesse or bellafill (permanent) is recommended.Good luck with your choices. Have a marvelous day.

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.  If you are able to wiggle or move the implant this might be an indication that your chin implant was placed within the soft tissue above the periosteum allowing the implant to move and be moved.  Placing the implant below that layer helps secure the implant.  You may need to have the current implant removed and replace it with an implant placed under the periosteum with a "forward" projection. 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.

What is wrong with my chin implant? I really dislike the downward projection. (photo)

Answers (3)

Recommended reading

Everything you need to know about Chin Implant

Our mission is to create a world where every investment in modern beauty is Worth It.

What is wrong with my chin implant? I really dislike the downward projection. (photo)

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Chin Implant

Our mission is to create a world where every investment in modern beauty is Worth It.