Thank you for your question.
You submitted your question with several very good photos.
And you state that you had rhinoplasty and chin implant placed 5 and half months ago.
You state that it appears that your left side of your chin protrudes more than the right
side and that on the right side, you had numbness in the beginning that’s gotten better.
However your lip droops a little bit on that side and there’s a problem with movement.
You state that you also have greater sensitivity in this area particularly at night.
So you’re asking whether or not there is swelling or shifting and some guidance as
to what to do.
I can certainly share with you my experience performing surgery as well as the experiences
of my colleagues who also perform this surgery.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Facial implants particularly chin implants is a very popular procedure and certainly
something that we do routinely in our practice.
I can certainly understand the challenges that you are facing right now.
And I think that as a basic rule of thumb, when an implant like a chin implant is placed,
it is certainly placed with some basic principles in mind and I think that most surgeons performing
this surgery do the procedure in that way and that means choosing the right size of
the implant.
Sometimes we basically use a rule of thumb.
Most women below a certain height, we say we’ll use a small implant and we sometimes
will use even sizers when placing the implant so that we know that the pocket that the implant
is going to be in is going to be appropriate.
And generally speaking, placement of chin implants is fairly routine.
But I can tell you that something that is routine can be somewhat complicated.
Especially in a city like ours, New York City, we have some really exceptional doctors who
perform this kind of surgery and I’ve seen plenty of the most prominent doctors even
have issues with chin implants requiring revision after revision.
I think that from my perspective that the symptoms that you are expressing and experiencing
is consistent with movement of the implant.
I think that your implant looked a certain way in the beginning and that you’re noticing
that with resolution of swelling that there is change in the direction of the relative
prominence and concurrently, you’re getting issues with sensitivity that there could be
some issues with part of the implant impinging on nerves on what’s called the mental nerve
which is the nerve that supplies the area of the lip and the lower teeth.
It’s very much possible.
Certainly there can be swelling and even though unlikely, fluid like a biofilm from a certain
type of infection.
Essentially, I think that you can have your doctor examine you and you can even get imaging
studies to look at the implant but I think that the clinical impression would be more
of a guidance to me as to the indication of whether or not to do something.
I think this is a kind of situation where at this point, it is not typical to have the
symptoms you’re having particularly with the sensitivity and significant symptoms at
night.
I think it’s likely that if the implant will be removed, those symptoms will get better.
I think this is something you should discuss with your doctor.
Again with the absence of a physical examination, I think the description that you’re providing
makes me think that there is something that is not quite right both in the physical appearance
as well as in the muscle function and of course the sensitivity.
I think that it makes sense, from this arm’s length view that removing the implant would
be appropriate.
It’s up to you and your surgeon to decide whether or not an implant exchange makes sense
depending on what the anatomy appears to be at the time that your surgeon decides to take
out the implant if the two of you make that decision.
So I hope that was helpful, I wish you the best of luck and thank you for your question.