Chin Implant

[Purist]

Over the past twelve months I've been turned down for jaw surgery by two hospitals with them stating various complications with my
jaw and teeth.  I have decided to no longer pursue this and I am now looking into camouflaging my retruded chin.

I spoke with a consultant earlier this week regarding a 9mm "off the shelf" chin implant. 

9mm will not cover the deficit but I feel will be enough to take it from a freakish looking chin to somewhat moderately retruded.

My concern is that the mentalis muscle is going to be strained too much and cause problems closing my mouth - I already
have mentalis strain.

The consultant said that the muscle can be partially cut during the operation or worse case, a series of botox injections to the chin will do. He did say a custom implant would be the best option but would increase the cost three fold.

I am due to see another consultant about a custom implant shortly.

What I want to avoid is the "witches chin" which may be a challenge for my degree of retrusion.

Decisions.

[Dharma]

Apparently, there is a great deal of disparity in surgeons ability to re-suspend the mentalis in a position that is both functional and esthetically successful, particularly after large advancements. Pick your surgeon wisely!

Have you considered genio vs implant? 

My surgeon has apparently done a number of genio's that were 8mm+ with a least 2 being 10mm for either sleep apnea or cases such as yours where jaw surgery is contraindicated.  I had a 10mm genio done 2 years ago in an attempt to help my sleep apnea without having to undergo MMA (which I underwent 5 weeks ago). 

My mentalis was stretched a great deal after the genio but I had no issues with chin ptosis afterward.  I did not have any hx of pre-existing mentalis strain, however.  Though we did it for functional reasons, I certainly benefited from it esthetically.  My apnea was improved but I eventually regressed back to severe apnea as my tissue laxed--so however tight things are after surgery, you can likely expect a great deal of "loosening" over 6 months to a year, if your experience is anything like mine. I have also heard this from others.   

After my MMA, where I was moved another ~10mm forward, my mentalis looked ok immediately post op, and then at week two, when we changed my bands, my mentalis began sneaking south and I began developing progressive chin ptosis.  After both of these surgeries, my tissues were so tight, I could not look up.  Strangely, my chin actually looks somewhat better than it did at week two but with certain facial expressions, I do have some degree of chin ptosis--the fat pad of my chin and the lower muscle bodies of the mentalis will sit just on or below the tip of my chin bone.  AT this point I'm so swollen from a procedure 2 days ago that its hard to tell where I'm at in terms of my chin at this point.  AGain, things seem to stretch/adjust a great deal over time after surgery.

Also consider that with bigger advancements in this area, you risk a greater likelihood of nerve damage.  After my 10mm genio, I ended up with some permanent sensory loss in my bottom incisors and right in the middle of my lower lip (only 3-4mm across and not full loss of sensation--I had about ~70%).  My sensory loss did not affect my life in any way really--kissing, eating/drinking, speaking were all good to go. 

 

 

[Purist]

Thanks for replying.

I have spoken with two consultants in the past regarding a genio. and on both occasions they advised against it.

My retrusion is so severe that a SG would make the chin appear "clumpy",  like someone stuck something on the end of it.  It would result in a "witches chin" appearance.

I'm not entirely sure why a chin implant is any different - perhaps it adds some width to the jawline?

[ditterbo]

I don't know how unique my experience is with chin implants, but if you need a chin implant to do that much mm of advancement for you, then don't skimp out and go get a custom chin implant.  You absolutely 100% do NOT want to deal with an implant wing swinging up because your jaw is too small and the wings are squeezed in to fit. Also, do not think of chin implant surgery as a 'minor' surgery that just any doctor can do, because as you noted it can go extremely wrong.  I have possibly permanent damage to my lower lip motor nerves!  I think the doctor used a screw that penetrated the muscle (it rose 3mm+ above the implant) and did that damage.  My mentalis muscle is now useless and won't pull down when I smile.  My op doc spun me in circles and now I'm probably f****** 1.5 years post op. Going to find a smile repair specialist soon hopefully just to confirm.  Oh and the revision chin implant has the EXACT same problem with the wing as the first one. Just get some peace of mind and go custom.  Note my current implant, also with an out of pocket wing, gives 12mm projection.  My review is on realself, same username.  Seriously, be careful with big implants on a small bone structure. 

An alternative, just to cover your bases, is a modest SG with a chin implant applied some time after that to cover step offs and complete the camouflage treatment.

[needadvancement]

My apnea was improved but I eventually regressed back to severe apnea as my tissue laxed--so however tight things are after surgery, you can likely expect a great deal of "loosening" over 6 months to a year, if your experience is anything like mine. I have also heard this from others.

This is why I plan to get some liposuction below the chin after my sliding genio as well to completely tighten the neck area. Do you think this may have happened to you due to some fat still resting below your jaw?