JonathanA

Met with another surgeon today who is a very close friend of the family and has quite a bit of experience with chin implants. He examined me very thoroughly - even reached into my mouth and felt the implant - and said that it seems quite stable. However, he said that a very slight shift may have caused nerve impingement, hence the discomfort.

Aesthetically, it looks SLIGHTLY asymmetrical. The numbness and pain has decreased a bit.

What would you do in my situation - replace the implant to improve symmetry or just leave it be?

Thanks again for all the support!

-Jonathan

robyne00

My decision would be based upon the following criteria, in this order:

1. Amount and level of pain/discomfort
2. How much the shift actually affects your appearance
3. How self conscious it makes you feel and/or how it affects your self esteem, self image, and self concept

Please let us know what you decide!

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JonathanA

Good to hear from you again, Robyne.

I'm seeing the following San Diego doctors next week:

Dr. Amir Karam
Dr. Roy David (formerly Dr. Roy David Amir)
Dr. Hilinski

If you have any strong opinions about any of these doctors, please shoot me a PM and let me know.

Thanks!

-Jon

AverageGuy

Hi Jonathan

I'm getting rhino and a chin implant in a few months and I'm wondering what to expect when I first awaken after the surgery ? I know each case can be different but I was wondering if you could share your experience ? did you awaken to alot of pain fom your chin ?

JonathanA

AverageGuy -

I had my procedure done over six years ago and don't remember it very well. I don't remember any severe pain, though, and was fortunate in recovering fairly quickly.

I'm sure you'll be fine. Best of luck to you!

-Jon

JonathanA

Saw the aforementioned doctors this week. Happy to share my experience - just PM me.

Holding off on removal for at least another month; just taking ibuprofen and hoping it goes away. If not, it looks like I have some options for revision surgery.

-Jon

la_angel

If the asymmetry is slight (as you say it is) that doesn't seem like reason enough IMO.

JonathanA

Thanks for all the help, everyone.

Thank you for all your help.

I opted to get a CT scan before committing to removal or replacement. Here are the findings:

1) Implant anterior to the mandible which crosses the right mental foramen. This could conceivably be compression of the right mental nerve. The superior margin of the implant is just inferior to the left mental foramen.

2) Minimal right sphenoid disease. Deviated septum. Paradoxical curvature of the middle turbinates.

What does the first finding, regarding the implant, suggest? Is the second - right sphenoid disease - anything to be worried about?

Thanks again.

-Jon

JonathanA

Update:

Returned to the first surgeon I saw today with the results of my x-ray and CT scan.

He spent about 20-25 minutes explaining how he would use the x-ray to determine the appropriate size of a new chin implant. His plan is to remove the current implant and replace it with a medium- to large-sized Implantech extended anatomical implant. The projection would be roughly double my current implant; my current implant is 2.5 - 3mm and the new one would be 5.6 - 6.2mm. The procedure would be performed under local with nerve blocks.

I liked that he spent a lot of time explaining the procedure and demonstrating what he would be doing. A custom-sized implant definitely seems like a good choice.

However, I think that 5.6-6.2mm might be too large. I don't like that the operation is performed in his office and not at a hospital or surgical center. Also, when the time came to ask questions, he seemed to be in a hurry to leave. He spent plenty of time explaining things beforehand, but he seemed rushed when I wanted to ask questions.

Any thoughts on this? The doctor has excellent credentials and pretty good before and after pictures, but I get a bit of a "chop shop" vibe...

Thanks!

-Jon