I'm booked in to the Clinic For You next week for...
I'm booked in to the Clinic For You next week for a chin implant. I've always been unhappy with my profile - or at least since I was a teenager and caught myself in a mirror that showed my profile. I've been researching for about 18 months, and looked at a lot of different options and surgeons. Decided I wanted a non-porous implant inserted sub-mentally, under local anaesthetic.
Having already had one procedure abroad, I'm not anxious about travelling to get this done. However as the date approaches I've found myself worrying a lot more about the expected outcome, whether there will be a lot of swelling, whether I'm going to look weird and if anyone will notice. I also have a disapproving partner who really isn't keen on the idea. So I have to deal with one other person's anxieties about this, too.
My desired outcome is for a more masculine face, with a stronger and more balanced profile. I don't want to be unrecognisable, I'm fairly happy with the way I look already. But I've always been unhappy with my chin and that insecurity seems to be getting worse.
Pre surgical check
18 Jan 2016
Day of treatment
today's the day! I arrived last night and got picked up from the airport. Checked in to my apartment but didn't sleep all that well.
The last few nights I've been having chin dreams and waking up wishing it was the day of the operation. So I'm excited but strangely calm today.
Just had my consultation with the surgeon. It's obviously quite a simple procedure for him so seems quite casual about it. I've also asked all the questions I needed to via email. He explained everything and translated via Eveline. Also took photos of my profile and the front. I arrived at about 9.30 but they're not operating until 3. Going for local anaesthetic with a muscle relaxant (similar to diazepam). I can call for pizza (really!) and have my own private room to hang out in. Wish me luck!
Surgery day (9 hour wait)
18 Jan 2016
Day of treatment
Was picked up slightly late (I wouldn't have minded if I didn't have to wait in the snow), driven to the clinic and had consultation.
The surgery itself was fairly easy to handle. I'd asked for a muscle relaxant before I went in- it was only given a few minutes before I was on the operating table so not sure how much effect it had.
Mainly the uncomfortable part is feeling the bone being scraped to separate the muscle, but I didn't feel the initial opening. A few times when I winced, the surgeon gave me a bit more anaesthetic. Afterwards I was fully bandaged up and wheeled into another room where I fell asleep.
The big frustration for today was having to wait 9 hours for surgery. Apparently there was an unexpected patient, but I don't think it was planned very well. Would have been much better for me to spend my time in town or in the apartment rather than in the waiting room.
Day 3 - fever is down, starting to see results. Still swollen
Monday night was quite tough, but I wasn't expecting to sleep well. on Tuesday I asked the surgeon for stronger painkillers as the ones I had weren't doing the trick. I think the issue is that I've also had a cold and it's flared up again, giving me a fever all through Tuesday. Luckily it seems to have subsided.
My post-surgical check went well, in all it took two hours between being picked up and dropped off again. I felt very self-conscious walking around with the bandage around my head but wasn't out for long. The surgeon said it was very swollen so he bandaged me up again (I think the original plan was to take it off yesterday morning)
The Big Reveal :
I finally took the bandage off on Tuesday night and it looks less dramatic than I thought it would. I was expecting it to be bigger. But on reflection, I think it's actually the right size for me. So far I'm happy with the way it looks :) One of my fears was that it would look noticeable and that people would realise- but I don't think anyone will.
Still very swollen, and the scar under my chin is still red/scabby. I was able to shower this morning and have been told to moisturise. I think when it's all healed up, the swelling has subsided and I can regrow my beard, it'll look good.
I was also most worried about numbness, but amazingly I don't seem to have any numbness in my lips, and hardly any in my chin. Good news!
Swelling has come down, easier to speak and eat
amazed at how quickly I'm recovering! I saw a friend who knew I was having this done and he said "presumably it won't look asymmetrical when it's healed properly". The reason is that I have quite a bit of swelling under the chin on my left side. It also gives me a bit of a double chin.
My partner is being a bit weird about the whole thing and says he "needs time to get used to it", but I think he can't see past the swelling. He also said it looked a lot less swollen this morning, which is good.
By now my speech is totally back to normal, I have no numbness except around the incision site, and only soreness when I do my chin massages (still not convinced they're necessary)
Clinic has asked me to send photos to them tomorrow so they can check my progress as I'm back in UK now. Will upload those tomorrow.
10 Day Update
Swelling has all but disappeared along the implant. The only real bump is around the incision which remains quite scabby and red. Hopefully it's not too visible because my beard is coming back, and overall it's less red than it was.
So my overall thoughts are; I'm happy with it! It's not exactly how I imagined it would look, but in many ways it's better. I still get chin-envy looking at other people with strong chins, but at least I am now not embarrassed by my profile. I used to hate standing side-on to people, and sometimes jutted my jaw out to make my chin a bit stronger. But now I don't have to do that. I also think in the oblique view it's beginning to look really good. Once the bump under my chin has come down it should look even better.
The only awkward thing is now bumping into friends who I haven't told, and thinking whether I'll tell them I did something, or ignore the subject. My partner says it isn't that noticeable, and my best friend said you really have to crane your neck to see under my chin, and not to worry about it.
What's it like to have a chin implant under local anaesthetic?
I'm writing this because I couldn't find a lot of information about having a chin implant placed under local. I didn't have sedation, I just had a muscle relaxant about 10 minutes before the procedure (so I'm not sure it really helped).
To begin with, if you're an anxious person and you dislike going to the dentist, this may not be the best way for you. It can be uncomfortable and a little unnerving, but on the other hand it is a fairly quick operation. I also had my eyes shut the whole way through, it would have been impossible to keep them open due to the very bright surgical light in theatre.
Injections : the surgeon gives you a few injections, the first of which hurt a bit. The good news is that it numbs the area immediately, and since you're totally awake you can tell him/her whether it's fully numb. The first few are more painful than the others. I had to get extra anaesthetic halfway through because he didn't numb far enough along the jawline.
Incision : this doesn't hurt, and was over in seconds.
Creating the pocket : this was the strangest part; if you've ever been to the dentist to have tartar removed, it feels like that. Feels like he's scraping your teeth to try to remove some plaque. It doesn't exactly hurt, but it might freak you out a bit. It's the act of separating the muscle from the bone so that the implant can go in there.
Placing the implant : Once the pocket's created, that's the worst thing done. I knew they were packing the implant in the pocket, but I couldn't really feel anything other than the sensation of having my chin pushed about a bit.
Sewing up : this only took a minute or so. They used a dis-solvable stitch which should disappear in 3-4 weeks. Then I was wheeled out on the trolley, not before being bandaged up. I promptly fell asleep in the recovery room. After that, I got in a taxi about half an hour later.
2 Weeks. Looking good, but incision is inflamed
Overall healing around the chin implant and the jawline has been fine. The only issue really is the incision -- I'm worried it's become infected because I've got a lump where one side of the stitches ended, and the incision site itself is still weeping. I've sent some images to the surgeon to see what he thinks. Worst case I'm thinking I may have to go to my GP for antibiotics, but will wait to see what Dr Piotr says. Good news is that it isn't too visible (hopefully). Not sure I want to put a photo of the incision at the moment because it's a bit gross.
2.5 weeks : chin implant removal
The antibiotics my GP was giving me didn't seem to be doing anything to lessen the bump under my chin, so I went back on Friday as requested. The GP immediately rang the plastic surgeon at a local hospital and gave me an urgent referral.
At the hospital, the registrar who saw me said that it would have to be opened up and cleaned, and there was little chance of saving the implant due to infection. Clearly, this was devastating. Earlier in the week I had been confident that everything was going well, and was pleased with the result. Now I was being told that I'd have to have it removed.
Saturday I returned to the hospital and was fasting as my procedure would be under general anaesthetic. I thought not eating for a whole day would be difficult, but in the end I was too nervous and anxious to feel hunger. At around 4pm I was told to get into my gown and then things started moving quickly. I saw the consultant when I was on the trolley, and he asked me about my procedure and asked whether I'd considered a genioplasty (I told him I thought it would have been too invasive). He was also surprised that they'd chosen an extra-oral approach, although I know that most surgeons choose this, so that was a bit strange.
It was my first time being under general, but the surgical team at St John's Hospital were very friendly and caring, and did their best to put me at ease.
I woke up and was bandaged up, wheeled back to my room and had a fairly pain-free night but the anxiety did stop me from sleeping earlier in the evening.
The next morning (yesterday), the surgeon came to see me again and told me that the implant was about to break through the skin, and that if we hadn't removed it it would have come out by its own accord in the next few days. Initially when the GP suggested the implant may have slipped I found it hard to believe, since I didn't think it would look like that. But it was confirmed in surgery, and perhaps I was slightly deluded in thinking that it was only an abscess (it was much harder than an abscess would be).
I'm glad i went in on Friday -- I had asked my GP whether it was worth waiting until Monday to see if anything improved, but if I had, the implant could have breached my skin. Good old NHS did me proud, and whilst it did involve waiting around all weekend, didn't cost me a penny - and the staff were excellent. They treated me pretty well, even though I'd had it done privately and probably should have returned to my original surgeon to get sorted out.
Psychologically it's difficult; on Friday I was upset, then angry. By Saturday I just felt grateful that I was being seen and sorted out quickly. My priority is just to recover from this and worry about getting another implant or some other surgery later in life. It is frustrating to think that I was happy with my result and then had to have it result. But I don't regret doing it -- I don't there was an option not to do it, as strange as that sounds. I'd become so obsessed with the idea that I could hardly let it go, and the fact that it failed is simply bad luck. I knew the risks before going into this, and knew this was one of the outcomes. Of course I didn't believe it would come to this, but what's happened has happened. Now I'm trying to focus on healing up and for things to return to normal.
Making peace with my chin; five weeks after removal
14 Mar 2016
2 months post
It seems a long time ago that I had the implant removed. I wasn't in much pain afterwards, but I did feel quite self-conscious as I had to wear a bandage for a few days, then a plaster under my chin. So I had to come out about having the chin implant done to a few more people.
Right now I'm feeling OK about my chin. I don't have as much projection as I did with the implant, but I feel it's not that bad as it is -- talking to a few friends afterwards has re-enforced that idea. I still get chin envy, and I do still think sometimes I could be 'tweaked' but at the moment I'm happy to leave it be.
One unpleasant side-effect has been that there's a bald patch under my chin now. There are some hairs growing through, but not a lot. The nurse told me it'll grow back but will be patchy for a while. I'm going to see how much comes back over the next few months.
I've been in touch with the original clinic and naturally enough, they don't want to take responsibility. I'm waiting to see the consultant at the end of April (in UK), and will get his verdict then.