Chin Implant Complications

1. The aesthetic size, shape and thickness (called projection) of the chin implant.  There is an aesthetic rule, within my Palmer Code beauty principles that defines the proper aesthetic balance of the chin in a man and a woman's face that I have used for over 25 years to make this determination.
2. The approach used to place the Chin Implant.  There are two ways to place a chin implant but I have always only used the external approach through a small curved incision under the chin.  When chin implants are placed through the mouth the attachment of the chin muscle must be cut in order to make the proper space for implant placement.  This causes the chin muscle to sag later in life (ptosis) and may also allow the implant to shift into the groove inside of the mouth.  I have dealt with both scenarios for chin implants placed elsewhere on numerous occasions, so this can and does happen.  When placed through the external approach, the muscle is lifted up but the attachment remains intact. 
3. The level of the chin implant placement.  It is advised that the implant be placed under the periosteum not within the superficial tissues.  This will secure the implant against moving.  Screws are not required to secure chin implants.
4. Typically, chin implant surgery can be done in less than 30 minutes.  There's minimal bruising and swelling.  There may be some mild restriction of movement/temporary numbness of the lower lip based on the added volume (from the implant) under the chin muscle.  This tends to decrease slowly over a few weeks.
5. If an inexperienced surgeon performs the chin implant surgery, there's an increased risk of damaging the marginal mandibular nerve that can lead to permanent loss of lower lip movement.  Like all treatments and procedures the number one goal is to find a plastic and cosmetic surgeon with the proper aesthetics of facial beauty...the second goal is to fine one with a vast experience.
6. Remember, you can always use a filler (I prefer Radiesse) as a non-surgical method of Chin Augmentation if you're not ready for a Chin Implant.  Over half of our chin and cheek implant consults are not candidates for implants and get fillers instead, so this is a real, viable option.

The complications from a chin implant will vary depending on the type of implant used. Various substances are currently used for chin implants including solid silicone, ePTFE (tradename Goretex), linear high-density polyethylene (tradename Medpor), the patient's own fat, and others.

During the implant procedure, there will be some bleeding and bleeding is possible for several days after surgery. Generally, this bleeding is not life threatening and does not come near requiring blood transfusions.

There is a nerve which provides sensation for the lower lip, lower face, and chin area which comes out of the lower jaw bone on either side just off the midline. This nerve can be bruised and stretched during surgery and, rarely, permanently damaged. This can create a temporary or possibly permanent numbness of the lower lip, lower face, and chin area. This does not in any way affect the movement of the lip but can cause some problems with drinking liquids due to lip numbness, much the same experience as after having injections at the dentist.

Infection is always a risk. If an implant is placed other than fat, infection may require implant removal. Often this can be avoided with prompt antibiotic treatment.

There is always a possibility of implant movement. This usually can be handled with conservative measures, though removal of the implant is possible.

Any implants will show some resorption of the bottom jaw bone over time. This is usually not a problem and can only be seen on x-ray. In people with very thin jaw bones this resorption can lead to breakage of the bone which would require repair but this is a rare complication.

As with any surgical procedure, other risks may pertain to your specific situation given other medical conditions. It is imperative to speak with a knowledgeable surgeon before undertaking any surgical procedures and disclose all of your medical conditions.

Possible complications that patients need to be aware of before surgery include:

• Infection
• Bleeding
• Nerve damage
• Mandible bony absorption (a small layer of bone fades away)
• Rejection of the implant
• Lip dysfunction
• Movement of the implant

As with any plastic surgery procedure, there are risks of infection and bleeding associated with having a chin implant. Fortunately, both of these are quite rare, especially if the implant is placed from under the chin where a sterile environment can be maintained during placement of the implant (as opposed to going through the mouth to place the implant).

In addition, there are risks of possible nerve and muscle damage from the chin implant. There are both sensory (sensation) nerves and motor (movement) nerves around the jaw that can be inadvertently injured during the procedure. Sometimes the muscle can also be affected from the implant, causing abnormal movement of the lower lip with a change in pattern of speech.

There is also a chance that the implant can cause absorption of the underlying jaw bone, which takes away from the desired effect of providing an augmented appearance. Finally, you may simply not like the appearance of your lower face following the chin implant procedure. Fortunately, a majority of patients undergoing this type of procedure end up fairly happy with their results with minimal complications.

A chin implant is a very simple device and the associated risks are straight forward: A chin implant can be placed into position either by an incision under the chin or through the mouth. With the external approach, there will be a visible scar (which is generally very hard to see). With either approach, there is a risk of an infection and the risk is higher when using the oral route. If the implant gets infected, it will need to be removed to clear the infection. The implant is placed along the jawbone and could potentially squeeze a sensory nerve that provides sensation to the lower lip and chin. There is a very small chance this nerve could be cut during surgery, but more often the nerve gets compressed and this results in altered sensation. The device may not lay smoothly along the jawbone, and might be palpable or visibly asymmetric. Finally, you might end up with more projection than what you wish. Most of these risks are true with any surgical operation and many are reversible by implant removal - speak with your surgeon to discuss any further concerns.

Dr.B

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There are risks to crossing the street or flying in an airplane and, of course, there are risks to any surgical procedure. These risks can occur regardless of surgeon or technique. These include but are not limited to: i

1. nfection,
2. hematoma,
3. discomfort,
4. wound breakdown,
5. hypertrophic scar formation,
6. asymmetry, unfavorable healing,
7. implant
   1. rotation,
   2. migration,
   3. infection,
   4. exposure,
   5. bony erosion,
   6. dental injury,
   7. nerve injury with diminished lip sensation (which can cause drooling),
   8. palpability,
   9. visibility,
   10. distortion with muscular contraction,
   11. biofilm formation with capsular contracture,
   12. interference with lip/chin sensation,
   13. need for secondary surgical revisions, an
   14. etc,

Although many otherclaims of diseases associated with silicone implants have been reported these have not been substantiated by major studies.