Can screw fixation to jaw/chin bones (to hold implants) fracture the bones?

I have been performing chin augmentation with solid silastic implants and titanium screw fixation for 30 years.  I have never had an implant shift position, get an infection or had a bone fracture from the screw fixation, and as such it has served as a perfect technical approach when improving facial balance with chin implants.  As with most sophisticated procedures that we endeavour to improve facial balance with-there is more than one way to achieve an endpoint, and some surgeons do not screw fixate their facial implants.  I do, because it works  well for me !!  My experience with screwing chin and cheek implants into position has been fantastic, and consequently it is an approach that I routinely perform and teach to our resident doctors in training.  I have never seen one of my screw fixated cheek or chin implants lead to or contribute to a facial fracture.  Best of luck to you in finding the right surgeon who can help yuou out !!

We have been using  Silastic chin implants which do not require screw fixation. Jaw implants do require at least one very tiny screw which  should not fracture angle of the mandible which is quite dense in that location

Old quip... get 10 different plastic surgeons in a room and you will get 11 different answers.  That means, there can be more than one good way to get to a good result and that choice depends upon the comfort and familiarity of the surgeon.  I like Porex, a rigid implant that feels like bone, has 2 parts so that it can fit on an uneven chin, and is screwed into place with titanium screws use in facial fractures.  This approach works best for me versus other options.  That does not mean the other options do not work well for other surgeons.  The mandible is a heavy bone and the screws are just over 1 mm diameter, so it would be unlikely that they would cause or contribute to a fracture.