8 weeks post-op and I can see that there is a gap/space in my gum where the implant is visible, am I rejecting the implant?

Question

I had a rhinoplasty with chin implant augmentation because it was suggested by the surgeon to improve my profile, a few days later I noticed i could see something transparent at the left side of the incision I was afraid it could be the implant I talked to the doctor about this and he says that effectively its the implant showing, he said i should wait till friday (5 more days), and if its not healed He'll take it off. he said I might be rejecting the implant, help please.

Michael P. Morrissette, DDS, FACS · Answer

Exposure of an implant 8 weeks post-surgery is a concern so be sure to follow-up with your surgeon. In some cases, the implant has to be removed and replaced at a later date. The most problem with implants is infection and/or migration. I have not seen any cases where a patient has rejected an implant based on the material of the implant.

Summit Kundaria, MD · Answer

losalero124,
Thanks for your question.  Implant migration is a possible complication of mandibular implants, and each approach has its own associated risk profiles.  In short, implants are more likely to extrude from the place they were inserted, as the soft tissue attachments in this area had to be surgically cut in order to place and accommodate the implant.  The most commonly placed implants are silastic, and rejection is a very rare occurrence, as your body walls the implant off with a thin wall of scar and then ignores it once it is placed.  I would continue to follow your surgeon's advice, and be prepared to have it removed in the future, as this rarely corrects itself if it is as you describe.  Good luck!

Michael Elam, MD (retired) · Answer

Dear losalero124, It is highly unlikely that your body is rejecting the implant. However it is likely that the implant is not correctly placed, to large and/or infected and thus needs to be removed immediately. I personally prefer to use a sub-mental approach (small incision under the chin) with chin augmentation as the likelihood of infection is greatly reduced when not placing the implant in through the mouth. I would see your surgeon right away for removal. Best regards, Michael V. Elam, M.D.

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

Hi, when the chin implant is placed through the mouth, the muscle attachments to the chin bone are cut in order to dissect further down on the bone and place the implant.  This allows the implant to migrate upward into the gingivobuccal sulcus.  That sounds like what has occurred.  This is why I prefer using a small, curved incision under the chin to place the chin implant.  This approach preserves the muscle attachment preventing implant migration. You might want to discuss a removal and replacement (using a submental skin incision) with your chin implant surgeon before the implant begins eroding through the inside lining of your mouth.I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  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.  In my opinion, you are a good candidate for chin implant surgery.  
Hope this helps

8 weeks post-op and I can see that there is a gap/space in my gum where the implant is visible, am I rejecting the implant?

Answers (4)

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