Chin Implant Complications - What do I need to be aware of before getting the implant? Can they "slip" out of place?

There are some general risks with any type on a surgical procedure including bruising, pain, possible risks of infection and anesthesia but in general chin augmentation is a short procedure with less than one week downtime most of the times.  As far as specific risks to this procedure, the main ones include:- Transient or permanent numbness of the portion of the jaw from a sensory nerve damage-  Asymmetry or possible displacement of the implant, and thus a need for revision- Suboptimal size of the implant, and thus need for replacement- Rare scenarios of muscle weakness of the chin or lipFor people who are particularly concerned about these risks or not so sure how they would feel following the surgery, the option of temporary filler for augmentation also exists with a lower risk profile. 

That is a great question
lingering in the minds of many prospective patients. The risks are an
Infection, bleeding, scarring, asymmetry/malposition and nerve damage. Although
the risks are very rare, prospective patients must be informed of them. The
chin implant is placed in a very small pocket of the chin between your bone and
skin, allowing for the implant to remain in place. If this dissection is done
correctly there should be no movement of the implant. If however the
pocket is too large the implant will shift with time. Additionally the
risk of damage to the mental nerve is important to consider. This will
lead to numbness of the lower lip. Often it is transient but
can be permanent. I understand the worry, yet there are many
benefits with moving forward with a Chin Augmentation and most patients are very
happy with their results. I hope this has helped.

The surgeon you choose should absolutely go over the risks and complications with you before performing any surgery. Nonetheless, the answer depends on route taken for inserting the implant. If the implant is placed by making an incision on the outside of your chin, which is commonly done, this lower position of insertion can, over the years, give the implant an area that it can slip into, since the dissection has created an area for future migration of the implant. For this reason, I prefer to place the implant through the intra-oral route, meaning through the mouth, which has two benefits: 1)the implant has no ability to migrate to this lower position and 2)no incisions can be seen, so no one will ever know you had surgery. If properly prepped in surgery, there is not any increase in infection with this approach, and the benefits are excellent. The surgery should be performed with the patient under anesthesia in a hospital or an accredited facility with sterile technique by a board certified plastic surgeon. Antibiotics are given through an IV during the procedure prophylactically while the patient is under anesthesia. Some surgeons also give antibiotics orally after the surgery to further prevent any risk of infection. I recommend consulting in person with a board-certified plastic surgeon to discuss your goals and expectations and see if a chin implant is the right procedure for you. It is overall a very safe and effective surgery that patients are satisfied with, as it enhances the balance and harmony of the face.

Thank you for your question and I appreciate your concern. While complications can occur after any surgery, those risks are minimized when you work with an experienced, board-certified facial plastic surgeon who has expertise in chin implant techniques. I only work with silicone implants, which can be easily customized to a precise shape for the most natural result. At the same time, silicone implants are very easy to remove if the patient decides to switch or remove the implant in the future. If you do not wish to make any changes, most of these implants offer permanent results. I advise you to choose your surgeon carefully, and you are very likely to be very happy with your outcome.

When a solid silicone implant is used, which is the most frequently type used today, there are essentially 3 most common complications from placement of a chin implant (known as "Augmentation Mentoplasty"):
1.  Numbness (known as paresthesia) of the lip and/or chin.  There is a nerve that exits the mandible (jaw) on either side of the chin called the mental nerve.  When placing the implant through the tiny incision of the skin under the chin, the nerve cannot be visualized.  During the procedure the full thickness of the soft tissues are elevated off the bone of the jaw in creating a precise pocket to place the implant into.  As the pocket is created, these soft tissues are pulled and pushed, in which the nerve lies.  Nerves are extremely delicate, and can easily "fall asleep" temporarily from this indirect manipulation, without EVER touching the nerve itself.  The mental nerve is only a sensory nerve, not a motor nerve.  Thus, it is not uncommon to temporarily lose some sensation on one or both sides of the lip and chin.  Nerves of the head and neck, if not cut, take weeks to months to recover, and rarely over a year if not permanently damaged.
2.  Malposition i.e. change of position the implant can occur.  This is very rare if the pocket is made very precise to the shape and size of the implant, and is secured to the bone.  Firmly attaching it to bone can be done with a single bone screw placed through the implant and into the jaw.  I prefer using an absorbable stitch placed through the implant and the lining of the bone, called the periosteum.  The ultimate goal, no matter which technique is used, is to maintain the proper position of the implant as the body creates a capsule around the implant the following several months, which is what ultimately holds it in place for you lifetime.
3. Infection is extremely rare.  With proper sterile technique, and also placement through the skin instead of through the mouth, infection is still possible, but very unlikely.  If it does occur, it is noted within the first several weeks of surgery, not after.  Treatment requires removal of the implant and oral antibiotics.  A new implant can be placed after the infection is completely resolved, and with proper sterile technique, because it happened once does not mean you have an increased possibility with the second implant.
Hope you found this answer helpful.  All the best!

Complications can occur with any surgery but the specific ones for chin implant include the following: scarring, bleeding, implant infection, numbness, muscle injury, migration of implant, lip drooping, anesthesia risk.  Seeking a plastic surgeon who specializes in facial surgery would help mitigate these risks. 

As with all cosmetic surgeries, we as surgeons are always augmenting or refining one area at the expense of another. The question is how to identify the right procedure for the right anatomy in order to minimize these risks to provide the best possible outcome. In chin implant surgery we are augmenting the chin with either a filler, or an implant. Chin implants, as foreign bodies, have the risk of becoming infected. In addition they can be malpositioned. An external incision will leave a scar but if properly placed will be inconspicuous. An internal incision can leave the mentalis muscle weak and prevent you from fully closing your mouth. As with any surgery, do your research. Ask a lot of questions and ask to see before and after photographs. Good luck to you. 

All complication of chin augmentation are covered in details by my colleagues. One statement that I may disagree is which incision (inside the mouth or bellow the chin) is safer. It doesn't  make  difference regarding placement of implant, accuracy of correction or incidence of implant infection whether intraoral or external incision is used. I usually let patient make that decision. Good oral hygiene after surgery and soft diet will eliminate problem with intraoral incision. I use silicone implants all the time due to wider range of shapes and sizes and ease of replacement if needed.  

We use Porex chin implants because they tend to have less risk of displacement than other types. It is very, very rare for displacement to occur.

Chin augmentations with implants are subject to the usual surgical potential dangers: infection, hematoma, seroma, and malpositioning.  Then there are specific dangers such as erosion of the mandible, assymetric prolapse of one side of the implant below the mandible which can be both visible and palpable.  Sensory loss to the lip and/or sensory or motor damage to the muscles that surround the lip are also possible.


The most common complication is malpositioning and this can be eliminated by placing titanium screws through the implant into the mandible.  This stabilization also decreases post operative swelling and speeds recovery.  I place all my implants in through the mouth; this leaves no visible scar and I've done several hundred without any sign of infection.