Many patients seek a change to the shape or volume of their chin (genioplasty) alone or in combination with other aesthetic enhancements such as rhinoplasty (“nose job” surgery or nose reshaping) or rhytidectomy (facelift or neck lift). In most cases, the desired procedure is chin augmentation (enlargement). Revision chin implant surgery (removal or replacement) is the procedure to correct or change the results of a prior chin augmentation procedure. When chin implant placement is unsatisfactory, the problem can be fixed. Dr. Ransom specializes in chin implant revision surgery.
The most common reason patients decide to revise a chin implant is that they do not like the size or shape of the implant selected by another surgeon. In the past, a common chin implant design was the “button” chin implant; this augmented only the center chin, and unfortunately made the chin look overly pointed or like a “witch’s chin”. Modern chin implants come in many sizes and shapes and can vary in design from more oval or rounded (feminine) to more square or boxy (masculine).
The second most common reason that patients seek secondary chin implant surgery is improper position or placement of the implant or migration of the implant after surgery. Some surgeons place chin implants through an incision inside the mouth, between the gums and the lower lip.
This approach often results in the implant being placed too high over the bone and can make the patient’s lower lip and chin look abnormal at rest or with movement. In addition, it is more difficult to adequately secure the implant via the transoral approach, and implants placed this way frequently migrate over time in response to the repeated contractions of the perioral musculature (lip and chin muscles) during chewing and speaking. In rare cases where the primary chin implant has become infected, it may be necessary to remove the implant and “cool off” the area with antibiotics for a few weeks after implant removal before proceeding with revision implant surgery (replacement).
Sometimes patients decide that they do not want chin augmentation. In these cases, the chin implant is removed via the same incision as it was placed, and the incision for access is then meticulously closed or revised as needed. With the implant removed, the patient’s face generally returns to its pre-operative appearance. If the implant that was removed was very large, it is possible that the underlying mandible (lower jaw bone) will be remodeled (flattened or thinned) or the overlying skin stretched and loose. In these cases, Dr. Ransom offers his patients the option of autologous fat grafting to fill in the facial volume deficiencies and scar revision to remove excess skin when possible. These procedures are typically undertaken after adequate healing from the implant removal has occurred, to better assess the contour abnormalities and to allow the wound to contract.
Revision chin implant surgery can be performed with local anesthesia or under light sedation and may accompany other cosmetic or reconstructive procedures. Chin implants can be an excellent complement to rhinoplasty or face and neck lift surgery. With subtle increases in the projection of the chin or the shape and contour of the chin and pre-jowl areas, significant improvements in the harmony between facial areas can be achieved. Dr. Ransom and his patients select from the most up-to-date implant designs to provide a modern aesthetic augmentation, avoiding extreme changes or unnatural shapes. He uses only biocompatible Silastic (silicone-based) implants, which have the lowest rate of complications of all the available materials.
Anyone who has had a chin implant placed but is unsatisfied with the result or has had complications may be a candidate for chin implant removal or revision. Chin implant removal or revision may be a stand-alone procedure or can be combined with other aesthetic or reconstructive surgeries. The key to any facial implant surgery is identifying the most appropriate size and shape of the implant – to achieve the greatest aesthetic enhancement, while still looking natural. Dr. Ransom understands that even a well-placed implant does not always give the desired effect. More information about placement and removal or revision of facial implants is available during your consultation.
Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.
Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.