What Are the Options of Chin Augmentation Other Than Silicone?

Question

I had a silicon chin implant surgery 4 years ago when I was 18. However there'd been noticeable bone resorption and the result, which was ok during the first year after the procedure, has become exceedingly unsatisfactory. I had a doctor look at my recent X-ray picture of my profile, and I was told the bone under the implant had resorbed to 1/2 its original thickness. I'll take out the silicon and get a different sort of augmentation. What are the pro n cons of Medpor? Fat transfer? Cartilage?

Anil R. Shah, MD · Answer

Greetings,
There are a variety of techniques to augment the chin.  Let’s examine the options:
Chin augmentation- offers a permanent solution in an in office setting and can be helpful for the majority of patients.  Can help adjust vertical and horizontal dimensions and a variety of shapes can be utilized.
Sliding genioplasty- A portion of bone is cut and extended with plates.  I find that there is often a gap in the cut portion of bone and often looks less natural if there is a bone gap.  Can be useful for long chins where increase in horizontal dimension is desired.
Fillers- Often don’t last long enough in the chin area due to movement but can be helpful to preview conservative changes.
Best,
Anil Shah

Earl Stephenson, Jr., MD, DDS, MBA · Answer

I agree with Dr. Epply that removal of your silicone implant and either a Medpor implant or sliding osteotomy with bone grafting would be a reasonable plan.

	Dr. ES

Kenneth Hughes, MD · Answer

If you have had a chin implant that has created bone resorption, osseous genioplasty may make more sense.  This would be difficult to determine without an exam.  Kenneth Hughes, MD Los Angeles, CA

Scott Trimas, MD · Answer

I am not a big fan of Medpor implants since they are almost impossible to remove if it becomes necessary. Other options include a goretex coated implant or a softer silastic implant. Fat transfer in my opinion does not have a very good success rate in that area and cartilage typically does not survive. I hope this information helps.

Barry L. Eppley, MD, DMD · Answer

Your options for non-silicone chin augmentation include Medpor implants or a sliding bony osteotomy. Each has advantages and disadvantages and which one may be better for you depends on a variety of issues. Fat transfers for bone augmentation are unpredictable and can't produce the same of degree of augmentation. While cartilage can be used it may also resorb and requires a rib graft harvest.

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