Chin augmentation with an implant is a common and relatively simple operation in most cases. However, like all plastic surgery procedures that require an implant to create much of the result, implant-related complications can occur. These complications may include improper or oversized implant size, infection and displacement, and implant malposition. Many chin implant problems can be resolved through simple revisions, such as adjusting the position of the implant or changing the size or shape of the implant.

A chin implant problem that poses a more difficult problem is fixing an implant that is too large or one that has to be removed in its entirety. Or the appearance of the chin after an implant has been removed, known as a “witch’s chin” deformity. The expanded soft tissues of the chin will not shrink and will return to the way they were before the implant was placed. Much like removing a breast implant, the expanded skin overlying it will sag after implant support is lost.

Soft tissue management of the chin due to implant expansion can be addressed in a number of ways. If augmentation of the original chin implant (but not an implant) is still desired, then the chin bone can be moved forward in a procedure known as osteoplastic genioplasty. The forward movement of the bone will serve the same purpose as the implant and will “re-expand” the soft tissue covering of the chin. The mentalis muscle can also be further tightened from inside the mouth where this operation is performed. If the implant is not to be replaced or was previously removed (and a new implant is not desired), then the skin and muscle must be re-tightened. This is done using the original incision under the chin (or a new one must be made if the chin implant was placed from inside the mouth). Loose muscle and skin are removed and tightened from below. This technique will prevent the chin tissue from sagging after a chin implant is removed or correct a witch’s chin deformity that exists due to a previous chin implant removal.

In some cases, it may be possible to lift and tighten sagging chin tissues from inside the mouth. This technique requires special anchors for bone sutures or screws placed in the bone over which sutures can be used to maintain the new position of the raised chin muscle.

Revision of shin implants requires knowledge and skill to perform a variety of chin procedures, including movement of the bone and methods to resuspend and re-tension loose chin tissues.