Nip This Tuck That

221 Responses to “Facial Implants (Cheek and Chin)!”

1. hi,
   i recently removed a maxillary implant placed on the sides of my nose and I was wondering if I would look different in anyway. I read somewhere that removing a facial implant causes facial deformality and the scar tissue results in a face that looks like it has loose skin.
   I am planning on replacing the implant in 6-12 months, after the original pocket closes. After I replace it, can I expect to have good results…considering all the scar tissue, etc?
   Any information would be greatly appreciated.
   thank you for your time.
   ginji

   ginji :: 1 month after

2. Hi Ginji,

   Thanks for your post. I’m not sure of the type, size and placement of your particular facial implant. That makes it impossible for me to answer your specific questions. I suggest that you go back to the Plastic & Cosmetic Surgeon that placed the facial implant and ask him/her those questions. In general the amount of excess skin and tissue that remains after a facial (Cheek, Chin) implants is removed depends on:
   1. The size of the facial implant…larger sizes have stretched the facial tissues more.
   2. The length of time the Cheek, Chin etc. implant was in the face….a longer period of time means the tissue was most likely stretched to a greater degree.
   3. The age of the patient. Younger patients tissues have a greater ability to shrink back down than older patients.

   Removing an implant from the Cheek and Chin..or other areas of the face does not automatically mean that the face will be left deformed. the amount of scarring, in the skin, from placing and later removing the facial implant is obviously increased but the actual scar amount is highly variable from patient to patient.

   What you didn’t say was why you had the implant placed in the first place….why you had it later removed and especially…why placing another implant is required. These are important issues that should be crystal clear in your mind before you have another implant surgery.

   Hope that helps…

   Dr. Francis Palmer

   drfpalmer :: 1 month after

3. Dr. Francis Palmer,
   Thank you for the information. Originally, I had the implant placed to fill in the depressions near my nose. I always felt that it wasn’t placed exactly where it should be because one side always felt uncomfortable. So, 2 years later, I decided to have it removed. I do want to put it back because I do not like having deep lines by my nose. I know that there are other alternatives, such as radiance, etc. But, I am only 26 years old and I do not want to go back for radiance every 6-12 months. An implant seems better, in view of costs and being more permanent.
   However, I am afraid of having disappointing results w/the placing the implant once again. Another plastic surgeon told me that the outcome of second surgerys, particularly dealing w/facial implants, are never as good/nice as the first surgery because of scar tissue, etc? My plastic surgeon disagrees, he said it depends.
   I am wondering if there is a “high” chance that the implant may shift back into the original pocket? Will the orignal pocket completely close…how long would u recommend I wait until reinserting the implant?
   Is it true that the outcome of secondary implant facial surgeries are not as nice as the first?
   Thank you so much for your feedback and time.
   Ginji

   ginji :: 1 month after

4. Hi Dr. Palmer,

   I am 30 years old and I had large cheek implants put in May, 1999 (approx 7 years ago). I asked for cheek implants because my cheekbones were flat and I wanted more definition. I am interested in having these removed for 2 reasons: (1) I am concerned about bone erosion caused by the implant, and (2) as I have gotten older, my face has thinned out and I fear that my face will only get thinner as I get older and the implants will look odd. I am concerned about the risks/complications associated with the removal of the implants and I was hoping that you might be able to provide additional info.

   Thank you in advance for your time.

   Sincerely,
   Valerie

   Valerie :: 5 months after

5. Hey Valerie,

   Bone erosion is pretty rare in cheek implants, so I’m not sure that’s something you need to be concerned about. The loss of facial fat, as one ages, however is a very real thing and it may make the cheeks look too large for your face. I suggest that you see a competent plastic and cosmetic surgeon that does a great deal of cheek implants…and go for evaluation and consultation.

   We exchange cheeks implants all the time…typically because the patients have had their cheek implants done elsewhere and don’t like the size, shape or positioning. I like using silastic cheek implants that are very easy to remove.

   Dr. Francis R Palmer, III

   drfpalmer :: 5 months, 1 week after

6. I had radiesse injection to my cheeks. It looks good in repose and pretty, but I think it made my face look much fatter when I smile and my smiling looks stiff on my upper lip. I had it done almost 3 weeks ago. I am thinking maybe that is because it is new, hard, and swollen right now and may soften up as time goes on? I really like it otherwise, and I wish it was permanent if it softens up. I also wonder if I had silicone cheek implants (small ones) would it feel hard and look fat when smiling also? I notice some of the movie stars have that look. I did take a chance because the lady who did it does do many cheeks, but she did a good job I think (and which is why I opted for a filler).

   Christy :: 5 months, 1 week after

7. P.S. By stiffness I mean that the upper lip does not rise up as much to show my upper teeth. It hangs much much lower after the radiesse injections. I hope this resolves.

   Christy :: 5 months, 1 week after

8. Hey Christy,

   It depends on how much and where the Radiesse was placed. Cheek Implants are permanent and yes, they may also give a temporary sensation of preventing raising the upper lip. You may consider a consultation with an experienced Plastic and Cosmetic Surgeon to discuss these options.
   Dr. Francis R Palmer III

   drfpalmer :: 5 months, 2 weeks after

9. Yes Christy…I understand what you are describing.

   Dr. Francis R Palmer, III

   drfpalmer :: 5 months, 2 weeks after

10. Hey Dr. Palmer…i notice my smile coming back today. It feels nice now. It did take almost over a month ! Not bad stuff (radiesse) at all.

    Christy :: 5 months, 3 weeks after

11. Hi Dr. Palmer:
    I had Radiesse injected into my chin yesterday (non-surgical chin enhancement) and I don’t know that I like the result. I had a couple of questions: 1) I spoke with my doctor’s office today regarding whether something can be injected to dissolve the Radiesse. My doctor’s office said that yes, there was something that can be injected to dissolve the Radiesse (should take a couple of days). I have researched crazily and have not found anything that promises to do this. Do you know if such a thing exists and what the side effects/consequences are of doing it? My 2nd question is: how long (in your experience) does the Radiesse last in chin augmentations? I’ve read that it can last anywhere from 1-5 years, but I was wondering what your experience was with it.

    Thank you in advance!
    Sincerely,
    Valerie

    Valerie :: 7 months after

12. Hi Dr palmer
    I had cheek implants about 10 years ago and ever since i have been able to move them up and down a little the back part of the implants are pretty fixed. I havent had any problem but is this okay. Thanks

    Chas :: 7 months, 4 weeks after

13. Well, you shouldn’t be able to move the implants. This doesn’t mean you have a problem or that you need to exchange them but this isn’t normal either. You might want to have a consultation with a plastic and cosmetic surgeon experienced with cheek implant augmentation.

    Reasons to exchange/remove cheek implants.
    1. you want a different size or shaped cheeks
    2. the implant(s) have dramatically shifted position on your face. Beware of manipulating them…you maymake them further dislodged.
    3. evidence of infection. Cheeks become red, tender and enlarged. Another reason not to touch and move them around.
    Dr. Francis R Palmer III

    drfpalmer :: 7 months, 4 weeks after

14. Hi Dr. Palmer,

    I had a chin implant 20 years ago (in 1988) by a well-known Beverly Hills surgeon who is now retired. I have never been happy with the implant. I am now considering having it removed. I believe it was a silicone button?

    Before doing so, I would like to know what my chin will look like after removal. Will it look like it was before (except for normal aging). I would like to have my natural chin back.

    Thank you.

    Dina

    Allie :: 8 months after

15. Hi Dina,

    I am familiar with the old silicone button chin implants. The look that they gave the chins were never my favorite and I rarely used them but I have removed them numerous times. Once the button implant is removed your chin tissues will not have support unless you place another, more aesthetically correct chin implant back in.

    Now, depending on the size of your current implant, the amount of excess chin tissue will vary. If you’re not going to put in anotehr chin implant, you may need a chin tuck which is typically performed at the time the chin implant is removed. The incsion is the same one used to remove the chin implant…I use one hidden under the chin.

    I do not advise having an incision for chin implant placement or removal inside the mouth as this can increase the risk of infection and cause permanent damage to the mentalis muscle attachments causing a droopy chin to occur at a later time.

    A simple examation of your chin will most likely provide the answers. Would help if you had an idea of how thick the button implant is and just so you know…spme of the older button implants actually have a silicone gel that can be damaged at removal…

    Dr. Francis Palmer

    drfpalmer :: 8 months after

16. Hi Dr Palmer
    I wrote about the cheek implants I had 10 years ago can I remove these without any problems will my face go back to original state i am 36 now the implants are not very big. Also I dont know if you want to comment on another doctor they were done by Dr Leslie Stevens.
    Thank You

    Chas :: 8 months after

17. Hi Dr. Palmer,

    I had a medium (female) silicone rubber chin implant placed about three and a half months ago from a popular Beverly Hills surgeon. I am going to be removing it in the next three months from the same surgeon because I am not happy with it. I am 19 years old, which means young skin. I am hoping for my chin to look the same as before, but I am a bit worried. Do you think there will be deformities, or is it unlikely? My surgeon told me there will not, and that my skin will snap back to place. Any information to give me in regards to this will be much appreciated. Thank you so much.

    Ciscandra :: 8 months, 2 weeks after

18. Hi Ciscandra,

    First, may I please say that there are no male and female implants only various sizes and thicknesses that the plastic and cosmetic surgeon must make the judgement of what would be appropriate for use on a woman versus a man. Sorry, had to get that off my chest…now to your question.

    In 4 months, it’s unlikely at your age that any significant stretching of your skin has been caused by the chin implant…but it’s not impossible. Any reason it’s not coming out sooner? Less time to stretch the skin. You should talk about this with the Plastic Surgeon that did the Chin Implant. I typically tape the chin up well after the implant is removed. You didn’t mention replacing the implant and it sounds like you’re looking for your pre-surgery chin back..is that correct? If so, you should get it barring any unforseen problems…but ask the surgeon who put the implant in to be certain.

    I have had to tuck the excess skin under the chin when large implants are removed.

    Dr. Francis R Palmer, III

    drfpalmer :: 8 months, 2 weeks after

19. I had a chin implant 8 weeks ago. Its too far left,w/arm under jaw line. How soon is it safe to fix it?

    Jodie :: 8 months, 3 weeks after

20. Hi Jodie,

    Off hand, I’d say 3 months, so you have 4 weeks left. By that time, the initial swelling should be gone and you would be able to get a good idea of where the ends of the Chin Implant are located. Be sure, it needs to be repositioned…by seeing the Plastic and Cosmetic Surgeon who performed the Chin Augmentation.
    Dr. Francis R Palmer, III

    drfpalmer :: 8 months, 3 weeks after

21. Dr. Palmer,
    I have been worried all day because I went to the dentist yesterday and received an anesthetic shot right next to my right nostril…in the area where my maxillary implant is. I have been worried that it is leaking as a result. I have been feeling both sides and seems like the right side is now smaller than the one on the left.
    What should I do? In the case that it did break, is it considered an emergency? And lastly, are there big complications in explanting such an implant?

    Thank you,
    Debby

    Debby :: 9 months after

22. p.s.- it was a silicone implant.

    Debby :: 9 months after

23. Hey Debby,

    Although I can’t give you specific advice regarding your Malar Augmentation (Cheek Implants), I can tell you that Silastic or Silicone Cheek Implants are solid and do not have any gel or liquid to leak. Please contact the Plastic and Cosmetic Surgeon that performed the Cheek Augmentation to be certain…but it’s unlikely that the needle damaged your silastic Cheek Implant.

    Dr. Francis R Palmer, III

    drfpalmer :: 9 months after

24. Dear Dr. Palmer,

    I’m an oral surgeon that has practiced for 35 years. I had a question in regard to the chin implants.

    In regard to your recommendation of extraoral incisions, I’ve entirely removed the attachments of the mentalis muscle several times in order to perform grafts and never had the problem of having a droopy chin afterwards. I’m not very familiar with facial implants, but I would like to know what is the reason why they provoke resorption of the underlying bone. Is it the pressure they make that provokes the resorption? What kind of implants don’t cause resorption?
    Thank you very much for your attention.

    Sincerely,
    Dr. Felix Pelcman

    Dr. Felix Pelcman :: 9 months, 1 week after

25. Hey Doc,

    Let’s see if I can’t give you some answers.

    1. The droopy chin can result from removing, cutting the Mentalis Muscle attachments and the external incision heals so well…I’m not sure why anyone would do the external incision for Chin Augmentation.

    2. I would guess that it’s a combination of pressure caused by the Chin Implant on the bone as well as persistent motion of the Chin Implant caused by the overlying muscles that causes bone erosion in some patients.

    3. I think all Chin Implants could potentially cause bone erosion…harder materials would seem more likely to erode bone than softer materials. I like Silastic Chin Implants for the many reasons stated on this blog.

    Good Luck. Hope this helps.
    Dr. Francis R Palmer, III

    drfpalmer :: 9 months, 1 week after

26. Hi Dr. Palmer!

    I had a chin implant 8 days ago. I want to remove it (with no replacement) now for several reasons:

    1. I didn’t do enough research and didn’t realize that bone erosion was a possiblity. I got the implant without any screws and I read that the chances of bone erosion is higher for ones done w/o screws. I specifically don’t want screws bc I read about potential calcification.

    2. My lower teeth are hurting the last few days and shifting - I didn’t know if it’s related to this, but it never hurt before. I can see that the implant is really close to my tooth bone.

    Basically if I had done more research before the operation, I wouldn’t have opted to do it. I did ask my surgeon what are all the risks but bone erosion was never mentioned.

    My question is:

    If I leave the implant in a little longer and the capsular tissue forms, then remove it, will I have ‘more’ of a chin after I remove it? (my PS told me that it happened to one of his patients who had it inserted and removed over 3x due to infections)

    A. If so, how long will I need to keep the implant in for?

    B. If not, and I remove the implant imediately, (say within 16 days after the implant insertion) will I look like before the surgery within a few weeks? (any hence loose skin etc…

    Other info:
    Implant material used: Silastic
    Size - medium, minimal wings
    Incision area - through the mouth
    Other - I also had a neck lipo done with the chin implant

    Many Thanks!!
    Chloe

    Chloe :: 10 months after

27. Sorry few other things, the lipo was done through under the chin and behind the ears. Other reason for removal includes my mental state not really ready for this change (changing my look, loosing myself etc..). I had a bleph a year back and loved it. It began a mini obession with plastic surgery, but never really doing anything else until now - the chin aug & lipo.

    Thank you for reading this and any insight on your part is greatly appreciated!

    Chloe

    Chloe :: 10 months after

28. sorry forgot, I’m 29 yrs old.

    Chloe =)

    Chloe :: 10 months after

29. Hi Chloe,

    It sounds like you are having buyers remorse about your chin implant…but 8 days after the surgery is typically not a good tiome to make major decisions about your Plastic and Cosmetic Surgery Procedure.

    I advise you to speak with a trusted fien or family member and really give this some thought. If you are unwilling to accept even the slightest possibility of bone erosion, you may decide to take out the implant but that does not always occur and I frequently use chin implants in my beverly hills practice.

    Aches and pains after surgery are normal. You have to give it a few months before evrything is healed. How do you like the look of your chin so far?

    Continue speaking with the plastic surgeon that performed the chin augmentation….take a deep breath and relax. No matter what your decision, if it’s made in the next couple of months chances are your skin will shrink back down and you’ll look like you did pre-op….no, the scarring or capsule will not augment your chin to any noticeable degree.

    Dr. Francis R Palmer, III

    drfpalmer :: 10 months, 1 week after

30. hi dr. palmer i am from INDIA.my name is shilpi .i look very simple girl people say i look good . my prob is tht i wan to have high cheekbones i mean very high beautiful round cheekbones..i have a round face .i m just 19 yrs old..so can suggest some good cheek implants iwanna get my implants done by u only for which i’l be coming to ur country soon ..plz help i want to look pretty & beautiful .

    shilpi :: 10 months, 2 weeks after

31. Hi Dr.Palmer,

    I had posted a message a while ago which you replied to. I am having my rubber silicone implant removed may 17. In May it will be the 6th month post-op. I found the size of my implant…so i figured you would have better judgment with this information. It gave me a 7mm projection. my doctor classified this as “medium” and that “there will be no sagging or dimpling due to my young skin.” I am 19. What are your feelings in regards to this? The implant seems to be in the shape of a half moon, curving around the chin, only extending a bit into my jawline.

    Ciscandra :: 10 months, 2 weeks after

32. I actually just found out it was an extended anatomical chin implant, 5mm in projection, and rubber silicone. Btw, it was not a terino extended anatomical chin implant which seems to be more square. On implantech.com it gives a full description.

    Ciscandra :: 10 months, 3 weeks after

33. Hey doctor palmer,
    i am writing because it has been 8days since my surgery to my chin and im really freaked out about it. I have talked to my mom and my boyfriend and they both think the chin implant projects out too far. I really want to get it removed because i am feeling so depressed right now with how i look. I was wondering if this is normal? I was also wondering if i do get my chin impant removed, how soon can it be done? Or if it is normal, how soon until the swelling will go down? I feel like i have a man-chin right now..and i am a 22 year old girl with a very delicate face besides the implant. please help. I am sooooo miserable and scared.

    DJ :: 1 year after

34. Hey DJ,

    OK…first take a deep breath and relax. It’s not unusual to have some swelling after a chin Augmentation with implant that makes the chin appear too large. You should know the size of the chin implant that was used. #1, 2, 3 or 4. Sometimes they are labeled small, medium, large and extra large. If you have a small chin implant (#1), most likely what you see is swelling. Ask your Plastic Surgeon what size was used and voice your concerns. He/she may just tell you that most of what you see right now will go down.

    If your chin implant is a silastic (silicone) implant it is typically quite easy to remove and can be done at anytime…..but most plastic surgeons would tell you to try and tough it out for at least 1 month to be sure that you don’t like the result and are asure that you want the implant removed. Hope this helps.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year after

35. thank you so much for responding, i am starting to feel a little better about it, getting used to it a little and whatnot…but i also had one cheek implant repositioned because it fell, and now i am thinking that my unsatisfaction with my chin really has to do with my cheek because on one side i like it and on the other side my cheek looks huge…i can tell its too low, again..and when i asked my doctor about it he said he put a larger size in and that that was the problem all along…i disagree, its in my body and i can feel that its off, i also dont understand why he wouldve put in a bigger one from the side that looks right! is this a normal practice? im very frustrated that this is still the case a second time around …honestly, i am feeling around in my cheek and it almost feels like there are two implants in there…like he never removed the first one…i know i probably sound a little crazy right now because i first said my chin, and now i am saying my cheek, but i think its because i didnt fully understand what was off with my face. I had my surgery on june 7 and its the 20th today. should it still be rediculously big? i can send you a photo if you like so you can get a view of it. thank you for taking time to write me back.
    ps. the chin implant was a 2 (my doctor said it was like the smallest one, but with wings)
    the cheek implant he put in was also a 2, but the one on the other side is a 1.

    DJ :: 1 year after

36. ps. they are both sillacone

    DJ :: 1 year after

37. pps. is it just as easy to remove a cheek implant? like could i remove it sooner than later? i talked to my doctor about this and i felt as though he was treating me like i was acting so silly…

    DJ :: 1 year after

38. Hey DJ,

    I’m not sure that I answered this so forgive me if I’m repeating myself. Silicone Implants are very easilly removed but be sure that you’ve waited 3-6 monthjs to allow the swelling and the tissues to heal before another operation.

    Yes, we do evaluate photos and offer phone consults. Ypu can e-mail my staff for further info at drfpalmer1@aol.com.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year after

39. There was a question about Artecol in the corners of the mouth and cheeks that I can’t seem to find. Here’s my reply. Kenalog (cortisone) is an anti-inflammatory steroid that is sometimes used to dissolve things in tissues of the body like scar tissue and yes some fillers like Radiesse. I am not sure that kenalog injections will dissolve the Artecol. You should ask the plastic surgeon that injected the sartecol and yes the kenalog is injected directly into the area that you’re trying to dissolve. The kenalog can also dissolve your own fatty tissue leading to depressions and deformmity, so it’s not something that should be taken lightly.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year after

40. Hey Dr Palmer,
    I am a 21 year old girl.
    I just got a chin implant 17 days ago -

    1. is that too soon to see the basic look of what it will be like? I feel like it is making my face look extremely long. Also, is it normal for the face to look longer with chin implants? I thought it was supposed to be the other way around

    2. My other problem with it is that i have a muscle in the center of my chin that kind of like a button shape - when i didnt have the chin implant it would poke out only when i smiled, now that its sitting on top of the implant i feel that it is making my chin look too prominant…Will this eventually go down with the swelling? or is the swelling basically gone by now for the projection of the tip of my chin?

    Im trying to decide if i should take it out soon so that my skin wont stretch.
    Oh, my doctor used a size medium sillacone implant

    Nita :: 1 year after

41. Hello Dr. Palmer, i just recently had a rhinoplasty and chin implant done. I am 4 days post op and i do not like my chin implant at all. I believe he used a # 2 anatomical silicone implant with wings, and the wings just doesn’t seem to go with my profile at all because i have a weak jaw also. so it seems as if it is popping out. I know it is pretty early to be freaking out about it, but the more i think of it, even after it heals, it will still not look natural with my face because of the protruding feeling of the wings. Also my head is not all that symmetrical so that makes it even more obvious for me. Please tell me if this is normal and if i should wait it out, or should i already talk to my doctor about taking it out and maybe jut replacing it with an implant that does not have “wings” . i might be a little more happier with that. Thanks

    Mark :: 1 year after

42. oh yeah, he said he was using a “small # 2″ at the pre-op appointment. i asked him earlier when the swelling would subside and he said in a week or so but i have yet to bring up the part the bothers me.

    Mark :: 1 year after

43. Hey Mark,

    Chin Augmentation can take a month or longer for the swelling to subside. I advise patients to wait at least a couple of months or more to be sure thet the chin is fully healed before making any judgements about whether they like the aesthetic result or not. The implant is very easy to remove as long as it’s silicone if you ultimately decide that it’s just not working for you. Bring this up the next time you see the plastic surgery who performed the surgery and discuss your concerns with him or her.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year after

44. Hey Mark,

    I should also mention that the smile and sensation of the lip and skin over the chin can all be disrupted for months after the chin augmentation. Typically this all resolves within 6 months after the surgery.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year after

45. I have a 10 year old chin implant that has sides to it.
    One side never appropriately fixed to the bone. Now it sticks out and looks strange. Also, when I laugh I also look strange (getting worse with age). I also have fairly large cheek implants.
    What can I do now???

    tricia :: 1 year, 1 month after

46. dear Dr. palmer,
    i had submalar implants put in exactly 6 days ago and i don’t like it at all. it looks really awkward. i dont know if it’s because of the swelling or not but im thinking of removing it..i just wanted to ask.. i heard it is fairly easy to remove cheek implants if it is silicone, but mine was a coral porous material..will it be hard to take out? and another thing i wanted to ask was.. can i remove these implants with local anesthesia and not general anesthesia?

    ann :: 1 year, 2 months after

47. Dear Dr. palmer,
    it’s the same person again.. i found out that those implants arent submalar implants but implants to fill in the depressions around the nose.. my questions from the previous posts still remain. I don’t like to go under general anesthesia because i just have worries about it..and i was wondering one more thing.. i have difficulty smiling and when i smile my upper teeth barely shows. it has been a week since getting the implants.. will these things fade away like the radiesse injections mentioned above? or are these things abnormal with implants.. it has been a week of my surgery.

    P>S please Dr. palmer..i am anxious and worried..please reply back when you can

    ann :: 1 year, 2 months after

48. Hey Ann,

    Yes it is possible to remove silicone implants from the cheeks under local anesthesia however, since AI don’t know about these coral implants…I’m not sure. You may want to contact the plastic surgeon who did the cheek augmentation and ask that question. Your post op swelling is obviously not subsided yet and be sure to factor that into your decision.

    Dr. Palmer

    drfpalmer :: 1 year, 2 months after

49. Dr. Palmer,

    Do you have anyone that you would recommend in the Atlanta area?

    tricia :: 1 year, 2 months after

50. Sorry, I have no idea.

    Dr. Francis Palmer

    drfpalmer :: 1 year, 2 months after

51. hai doctor…
    im planing to do chin and cheek implants..
    im planing to make my cheeks slim and my chin more sharp and nice.but rite now im wearing braces..so can i do the surgery??will there be any side affects??is it after i did this surgery i need to stop cheecking the dentist??
    please tell me??

    lia :: 1 year, 2 months after

52. Hey,

    I’m 19 years old and had a chin implant put in a little over a year ago and I am still not happy with it. I feel that it has made my chin too wide from the front, although I really like the changes it has made to my profile. Though I’m not completely sure the type of implant is, I think it is a silicone implant and my doctor told me that it went up into my jaw bone as well- so I am assuming it is an extended anatomical implant. I’m interested in getting it replaced with an implant without the wings on the side. I have a few questions though:
    Will this allow me to get my old jawline back while keeping the added projection from the side? (although I know it won’t be exactly the same, I just hope it will be thinner like it was before).
    What are the complications that result from this surgery?
    If my doctor put the implant in from under my chin, what is the risk of drooping/sagging with replacing it the same way?
    How long will it take for this to heal- will it take longer than the first implant to heal?

    Thanks so much for your time.
    -Chloe

    Chloe :: 1 year, 2 months after

53. Hey Chloe,

    Be careful about chin implants that do not have the tapering sides, you call them wings, as these tend to make the chin look elongated like a Pharoh’s chin…not a good look. Another option is a smaller, more rounded anatomical implant version.
    Revision Chin Augmentation is quite easy and the recovery time is quicker than the primary chin augmentation because the tissue plains have already been elevated. Sounds like you need a consultation with a plastic and cosmetic surgeon about the issue. Hope this helps.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 2 months after

54. Hey Lia,

    I would have no problem doing those surgeries with your braces on if you were my patient but I guess it will depend on the plastic and cosmetic surgeon that you choose to perform your procedures…they may or may not agree with me.
    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 2 months after

55. hai doctor..
    i would like to ask another question to u…
    after i did my chin and cheek implant can i still continue see the dentist to change my braces???
    this is due to i need to change it every 1 month..
    so can i do it after i did the surgery???
    is there will be any side effects???
    thank you..

    lia :: 1 year, 2 months after

56. Dear Doctor,
    i had cheek implants put in 7 months ago. they were silicone and fixed with sutures. one is too close to my eye and i want to move it. is there a way of doing this without surgery. i was told contiual massage could make it shift
    thanks

    toby :: 1 year, 3 months after

57. Hey Toby,

    Typically the Cheek Implants are stable in their position after 1 month. I trim the raised flange on the Cheek Implants during placement to avoid it being felt and/or seen along the lower eyelid. I don’t believe that there’s a way to make the Cheek Implant move down away from your eye socket at this late date without surgery (locally trim down that area or completely re-position the entire cheek implant)but you’ll have to ask the plastic surgeon who did your Cheek Augmentation that question.

    Cheek Implants don’t move much when I put them in for almost 20 years now performing this procedure quite often….I don’t use internal fixation methods nor do I use external sutures (these have to be removed after 1 week) and the Cheek Implants are not stable in position for about 1 month…so the external sutures really aren’t around long enough to be of much use. I do have all of my Cheek and Chin Augmentation patients use a U-shaped pillow to sleep on for the forst month. This avoids sleeping on your chin or cheeks that will potentially move the implants after surgery.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 3 months after

58. Dear doctor Palmer,

    First off: thank you for this great site and for all the useful information you post on it.

    I got a chin implant 2 years ago. Since it gave too much inferior projection and was far too wide in the midlateral zone, I had it removed 2 weeks ago. I’m scheduled to get a new implant in 4 weeks. I have two questions I hope you may be able to answer:
    1. When I asked my plastic surgeon for high central -instead of submental- augmentation, he suggested a chin implant with no/small tapered sides, since I don’t need midlateral augmentation. You told Chloe on this page to be careful with chin implants without tapered sides. Would the ‘anatomical chin implant’ from Implantech be a good compromise?
    2. Although less than last week, I can still feel there’s some fluid in the pocket. Will 4 weeks be enough time for the periost to reattach to the bone? I’m kinda worried my new implant will move into the old pocket. I should note my plastic surgeon only used some steristrips over the wound, and didn’t use any other dressing to force the pocket to disappear.

    Thanks in advance for your time and knowledge

    Cornelis :: 1 year, 4 months after

59. Cornelis,

    In my opinion chin implants that don’t taper at the sides elongate the chin in an abnormal fashion giving the patient a Pharoh’s Chin….an anatomical implant is more aesthetically correct again in my opinion.

    4 weeks is not enough time for the tissues to re-adhere…your suspicions are correct. I would think more on the order of 4-6 months.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

60. Dear Dr. Palmer,

    thank you so much for your advice.

    Cornelis :: 1 year, 4 months after

61. You are very welcome…spread the word.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

62. Hi Dr. Palmer,
    I just came across this site. Thank you so much for it. I had rhinoplasty at the age of 19 (I’m now 35) the Dr. who performed the surgery strongly suggested cheek implants and I was too timid at the time to say no. I do know that he made a small incision near my sideburns on each side but i don’t know what type of material he used. I’ve gone to a couple of docs to have them removed (I hate them, the implants not the docs, lol ) and all have said no. I had revision rhino by a prominant BH plastic surgeon 3 years ago and even he wouldn’t remove them. Can you help? Thanks

    Bobby :: 1 year, 4 months after

63. Bobby,

    Is the doctor still around who placed the cheek implants. If so, call the office and see what material the cheek implants are made of…this is very important. If the implants are silastic, they should be able to be removed. I’m curious why 3 plastic surgeons have told you they couldn’t or wouldn’t remove them. What did the plastic surgeons give as their reason?

    You can always come for a consultation and yes, I remove many cheek and chin implants that patients don’t like for various reasons that were placed by other plastic surgeons….I believ that this is just an aesthetic difference in opinion. You can e-mail us pictures of your face front, profile and 3/4 view as jpegs to drfpalmer1@aol.com or call to schedule your consult 310-652-9583.

    If you can’t determine the material of the cheek implants, I’ll have to order a facial CT scan to try and determine the composition of the implants. Medpore and the older glass implants can’t be removed, so let’s pray they’re not that type of cheek implant.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

64. Dr. Palmer,
    Thanks for getting back to me so quickly, that shows a lot of integrity. The plastic surgeon who performed my surgery was named Julius Newman and he was already ancient 15 years ago so I’m assuming he’s passed away by now. I wouldn’t even know who to contact.

    I’m guessing that the other plastic surgeons were wary of possible damage to facial muscles or nerve damage if something went wrong and that’s why they didn’t want to remove them. Just a hunch.

    I’m no longer living in SoCal but I do visit family so I’ll make an appointment next time I’m out there. Again, thanks.

    Bobby :: 1 year, 4 months after

65. You’re welcome.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

66. Hi Dr Palmer,

    I am a 37 year old man, I have had jaw implants in the past (5 years ago) to widen my lower face, I recently had a chin implant done and it seemed to elongate my face, are there chin implants that can widen instead of elongate the face but still give a man a square musculine chin? Also I have seen a few Plastic Surgeons and most seem to agree that I am lacking in the cheek area. I am absolutely terrified of cheek implants for men because I an afraid of looking odd and/or feminine but most importantly of looking “made up” I had a male friend of mine that had cheek implants and some of my other friends nicknamed him Madame (the puppet on the Hollywood squares from the 80’s) Sad that people can be so cruel. I was wondering how your selection of cheek implants differs and what you do to avoid the “puppet” look. Can a facelift or midface lift be used to elevate the cheek pad and make it look more pleasing? Last question, does a facelift tighten and restore facial contour or is it something reserved for older loose skin? Thank you in advance for your reply!

    Mark

    Mark :: 1 year, 4 months after

67. Hey Mark,

    Chin implants work great and I have had no issues with them for 20 years. The same with cheek implants. As I have stated in this blog many times…there is no magic in the implants themselves but in the aesthetic eye and surgical skill/experience of the plastic and cosmetic surgeon using them.

    You should be able to get a nice aesthetic improvement using the proper size and shaped chin implant. The same with the cheeks. Now, the poor friend who looked odd must of had an improper size and shaped set of cheek implants. A smaller, more narrow and subtle pair would have been more aesthetically pleasing. You may want to visit my website and read more about cheek and chin augmentation.
    http://www.drfpalmer.com/CheekImplants.html

    Facelifts do not restore facial contour but remove excess skin and tighten the underlying SMAS layer. Facial contour, which is at the facial bone level, exists or it does not. If it doesn’t, removing skin gives the windswept, operated look unless facial contour is re-established using implants or Radiesse injections. Again, aesthetic judgement is key. The cheek pad is fat, which does not respond well to sutures that tend to just pull through. Take a look at my “Celebrity Lift”. http://www.drfpalmer.com/PalmerCelebrityLift.html

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

68. Dear Dr. Palmer,
    I had chin implant placed 20 months ago. I felt it was out of place. My surgeon revealed that he’d put it above the periosteum. It migrated. 6 months later, he charged me $$$ again to open up the pocket and place a suture into the muscle to “anchor” it. The implant is now migrated to just below the vermelion border of my lower lip. Is it common practice to place the implant above the periosteum? Everything I’ve read says to place it sub-periosteally. I now have chronic jaw discomfort. Thanks

    Nikki L :: 1 year, 4 months after

69. Hey Nikki,

    Yes, there are some plastic and cosmetic surgeons that place chin implants above the periosteum. I believe that most plastic surgeons however feel it’s better to use the sub-periosteal approach and I have done so for over 20 years. It really doesn’t matter what was done previously as the chin implant has moved and may erode into your mouth if nothong is done.

    You didn’t mention how the original chin implant was placed…from an incision under the chin (my preferred method) or through an intra-oral approach. The intra-oral approach, in my opinion, has multiple disadvantages including possible upward migration of the implant to the mental sulcus.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

70. Dear Dr. Palmer,
    Thank you for your rapid response. You are very generous to donate your time to patients on this message board. My surgeon chose to use the intraoral technique both times to avoid external scars. I spoke with him today and he suggested we go back a 3rd time and open up the pocket and “put many more sutures in to secure it.” He said that the probable reason for the implant migration was because of the shape of my chin. I said “No, sutures didn’t work last time. I think this particular implant needs to come out.” Dr. Palmer, do you suggest I have him take it out and let my face heal a few months before attempting re-insertion? Or do you suggest I have hime replace the implant (smaller?) in one procedure. I am the main breadwinner in my family and I can’t afford to keep taking time off for this elective surgery and all the attempted revisions. At the same time, I want this to be done right so I can have some resolution to this chin implant issue. My doctor has very good credentials and I want to trust him but I’m afraid of being disappointed again.

    Nikki L :: 1 year, 4 months after

71. Nikki,

    That’s the million dollar question…trying to predict the future. If you’re trying to hedge your bets, you might consider taking out the chin implant through a small incision under your chin under local anesthesia. This will have just a few days recovery and you should be able to resume work at that time but avoid strenuous activity for 2 weeks. let the area heal for 6 months and then replace another implant through the same incision under the chin. Just my opinion.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 4 months after

72. Hello Doctor, I have several questions for you and may be calling on your expertise to correct these issues.

    1. I had chin and cheek implants 2.5 weeks ago, I feel there is some asymmetry going on with the cheek implants.

    The left cheek implant side seems to protrude outward much more then right side,and you can see the implant it seems.

    On the right side you can barley tell I have an implant, is the left side just very swollen? have you run into this before? is this the way it’s going to stay?

    2. On the chin implant the wing on the right side seems to have turned downward some how? I can clearly feel it, almost like it snagged up on something and turned downward, have you seen this before? is it correctable?

    3. How long does it take for numbness to go away on the corners of my upper lip? also numb on the left side of my chin.

    thank you so much, your words will stop my mind from racing, and get on the path to correct these issues with the right P.S

    Jesse :: 1 year, 5 months after

73. Not sure if you would want to know this but the cheek and chin implants were done through incisions in my mouth, hence the numbness…

    Jesse :: 1 year, 5 months after

74. Hey Jesse,

    First, the numbness. This typically resolves within the first several months, slowly. If you feel a section of the implant below the rest, this may be the way the Chin Implant was placed. If you think you feel the edge of one of the Cheek Implants, again this may be the way the Cheek Implant was placed. Did the Plastic Surgeon use the same thickness cheek implant on both sides? It’s not unusual for one cheek to be more swollen than the other. Has your plastic surgeon recommended icing your face after the chin and cheek augmentation? If not, perhaps you could call the office and ask for their specific instructions on reducing the post op swelling. All that being said, you should give your face a month or two for most of the swelling to subside before making any decisions.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 5 months after

75. Thank you so much for your quick reply!!! I should have explained that I showed my PS the chin implant and cheek implants before posting this, he said he beleives the chin implant moved, and the wing on the right side should be going upwards to sideways along the jawline, not torqued downwards. If you place your finger along my jawline you can feel the tip of the wing beneath the jawline at a downward angle, thats is why I was wondering if it could have hit some tissue or something? like a wall then the only way to go for the wing was down?

    He also said going through the mouth you are going in blindly so it hard to place perfectly (thought to myself then why didn’t you place it from under the chin?…)

    He took pictures of my front and side views, to see if it is swelling or a misplaced cheek implant, and told me to come back in 2 weeks.

    I am glad you said it is not unusal for one cheek to be more swollen than the other, so you are saying this would cause one implant to look more bulged out than the other one right?

    Thank you so much doctor! you should feel good about calming all of us that are in such a bad way mentally about these problems.

    If I ever get the chance to recommend you I will without hesitation!

    Jesse :: 1 year, 5 months after

76. Jesse,

    Thanks. No, there are no tissue walls to block proper placement of the chin implant. You lift the covering of the bone and make the appropriate space for the implant. I don’t use or like the intra-oral approach for chin implants for a variety of reasons.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 5 months after

77. I had cheek implants 2 months ago, and still have facial nerve pain - how long should I wait before I have to worry about it being permanent?

    THANK YOU

    Gina :: 1 year, 5 months after

78. Gina,

    It’s a bit unusual to still have nerve pain after 2 months with Cheek Implants, in my opinion. You may want to see your Plastic Surgeon who did the cheek augmentation and get his/her take on the issue. Let us all know how it turns out.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 5 months after

79. Hello, I also had cheek and chin implants, my problem is I am having upper lip weakness and numbness in the upper lip, like I can’t puff out my cheeks fully without holding my upper lip down, like theres no pressure, or spit right ect, or pucker right, I can’t keep my upper lip down with resistence when I push it up, I can do all these things but not fully it seems with pressure (pucker, puff out cheeks ect)

    Is this common or uncommon after these procedures? should I be worried? It’s almost been a month now… thanks in advance

    Justin

    Justin :: 1 year, 5 months after

80. Justin,

    It’s not uncommon to have that for a month or 2 after cheek augmentation with cheek implants that are placed through the mouth. You can also have temporary weakness of the lower lip from the chin implant and both could be causing added issues but this should be temporary. If you’re concerned however, you should bring this up to the plastic surgeon that did your cheek and chin implants.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 5 months after

81. Hi Dr. Palmer,

    I had a jaw implant attached to the left side of my jaw bone about a year ago. This implant was to improve the side effects of mandibular prognathism. I have severe asymmetry and the implant was to minimize this appearance. After one year post-op, I am still unhappy with the results. I chose to use an implant versus jaw surgery because I had a tough experience with oral surgery when I was 15 years old. I am 25 years old and I now have made an appointment with an oral surgeron. I’m reconsidering jaw surgery again. My question for you is: Will skin sag once my implant is removed? I have a quite large implant screwed to my jaw bone. Also, what are some other side effects of removing a jaw implant one year post-op?

    Thank you for any insight!
    Kristin

    Kristin :: 1 year, 5 months after

82. Kristin,

    The Oral Surgeon will have some definite answers for you during your consult but in general there would be some extra skin after the jaw inplant was removed. The younger the patient , say in 20’s, the greater the chance this extra skin would tighten back up. Good Luck.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 5 months after

83. Dr. Palmer,

    I’ve searched all over the internet for information and support regarding chin implant problems, and you seem to be the only help available. Thank you for publishing this blog.

    I’m a 40 year-old female and have been going to a cosmetic surgeon in my area for a few years for Botox and Restylane. I asked my Doctor about Thermage for some skin laxity and he suggested a chin implant instead. We did decide to add the Skin-Tyte procedure to this. (4 sessions)

    Six weeks ago I got the chin implant (I think small silicone) through an external under-chin incision, and some liposuction under the chin along with the first session of the Skin-Tyte.

    At this point the under-chin/neck sagging and profile is improved a bit. However, the overall shape of my face has me truly upset. I feel that the implant has aged me about 10 years.

    My face is squarer (and I think more masculine) from the front and now marionette lines have appeared around my mouth, but more like folds.. I feel that the skin is pulling at my mouth, making me scowl. Food is getting caught in the now larger space in front of my lower teeth. And it even seems to be pulling at my eyes a little. I can barely smile due to the skin tightness and it is interfering with my speech.

    At first The Doctor was assuring me that all this was due to swelling, but it is not getting any better.

    My question is, have you seen chin implants dramatically change the way the skin lays on the face, and what would be a possible course of remediation? If I have the implant removed will my chin and neck start to sag? Do you think about the next 3 sessions of the Skin-Tyte might help?

    Thank you!

    Mae

    Mae :: 1 year, 5 months after

84. Mae,

    It’s not uncommon to have restricted facial movement after a Cheek or Chin implant. This typically resolves over 2-6 months. The appearrance is another matter and one you’ll need to discuss with the plastic surgeon that did your chin augmentation with an implant. If after a reasonable time (several months) you don’t like the look….you might consider removing the chin implant. It’s unlikely that a chin implant would effect facial tissues around the mouth causing sagging….removing it however might.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 5 months after

85. Dr. Palmer have you heard of Livefill Filler? Do you perform this in your office? it’s suppose to be permanant filler, The only one I have heard that does it is Dr. Molleken

    Do you also perform midface life or cheeklift? can this be done after the buccal fats pads have benn removed?

    Thanks

    Jesse :: 1 year, 6 months after

86. Just read my message and full of spelling errors sorry, was rushing through…want to make sure you know what I’m saying..

    Dr. Palmer have you heard of Livefill Filler? Do you perform this in your office? it’s suppose to be permanent filler, The only one I have heard that does it is Dr. Molleken

    Do you also perform midface lift or cheeklift? can this be done after the buccal fats pads have been removed?

    Thanks

    Jesse :: 1 year, 6 months after

87. Jesse,

    Have not heard of Livefill and am not a big fan of any permanent filler. The problem with all of them is that the tissues of the face shift with age…I figure after 3-4 years and the permanent filler becomes part of the aging problem in the nasolabial folds and not part of the solution. I do a “Celebrity Lift” faetured on “The View” and shape the cheeks with Cheek Implants or Radiesse Injections because I believe this to be far superior to any cheek lift. In extreme cases of facial aging, I do perform midline facelifts but not at the sub-perieosteal level as this causes the “cat-eye” deformity.

    Read more here: http://www.drfpalmer.com/PalmerCelebrityLift.html

    You may want to come in for a consultation to address your specific needs. 310-652-9583

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 6 months after

88. It says the Radiesse Injections last 12-24 months, excuse the silly question but would it last that long if I work out a lot and sweat + use a sauna- steam room? Will the injection be aborbed or go away?

    I am a male and my cheeks have gone flat at 39 years old. My current cheek implants did not help because the PS placed them high on my cheek bone which did not address the flatness by the nose and submalar. Which was my real concern and hence the questions I have been asking.

    I take it you would remove my current cheek implants and put in ones that actaully make my cheeks look fuller in the submalar region, then use the injections, is there an email where I can send you some pictures then you could give me your opinion on what I need and the cost? I would need to plan this out to come to California.

    Thank you Dr Palmer

    Jesse :: 1 year, 6 months after

89. Jesse,

    The sauna and working out won’t effect the Radiesse and I would typically use one or the other (Cheek Implants or Radiesse), not both. Yes, I think you might consider removing and replacing the cheek implants. Yes, we have patients from all over the world and as such offer the ability to e-mail us jpeg pictures at drfpalmer1@aol.com and then schedule follow up telephone consultation (310-652-9583) where we discuss the pictures, your options and the costs. With Cheek Implants, we would ask that you stay in the LA area for about 1 week after your surgery. After that time, you could fly home.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 6 months after

90. I will take the pictures tonight and send them, Then tommorrow I will schedule a consultation with you.

    Thanks
    Jesse

    Jesse :: 1 year, 6 months after

91. That would be fine.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 6 months after

92. Hello Dr. Palmer,

    Thank you very much for your time in giving us much needed info.
    I’m a 39yr old female. I had cheek implants combined with Radiesse a month ago. Implants were silicone (implatech), Med size 4.
    I think my face looks odd, seems like my cheeks are too wide (seem wider than my temples)and too puffy.
    Dr said a week ago that I was still swollen & that I would be happy w/final results.
    My relatives so far don’t like them since it makes my round face look fatter & my eyes look sunk.
    I have problems with the middle of my upper lip, can’t speak very well and I don’t have much of a smile.
    How long should I wait for final results?
    How soon can I remove them?
    Will I get my smile back once they’re removed?
    I have been unemployed for several months & was hoping that a month after the surgery I was going to be ready to go back but now I don’t know if I should remove them now to avoid sagging before getting a new job.

    thank you,
    silvia

    silvia :: 1 year, 6 months after

93. Hey Silvia,

    OK…let’s take a deep breath first.

    1. You may want to wait a couple more months until you see the final result. From an aesthetic standpoint, I like the Large sized cheek implants from Implantech 3 or 4 mmm’s for women. The medium may make the face appear a bit angular. However, this is my opinion. Your Plastic Surgeon may feel otherwise.

    2. If the cheeks appear too wide, the implants may be placed a bit too lateral (towards your ears)…I don’t know as I didn’t put them in…but after a couple more months you’ll basically have what it will be.

    3. Smile, speech and facial movements can all be a bit off for the first couple of months….should resolve slowly.

    4. No real timeframe to have them removed but logically, I’d say 3-6 months….by then the tissues are healed so another surgery can be performed assumming you still don’t like them. You may want another opinion at that time.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 6 months after

94. Hello Dr. Francis R Palmer I`m a 25 year old woman I had my cheek implants done in 2002 in L.A, one is higher than the other and i think there a pit small for my face .is it Possible to have them removed and replaced by new ones ? what is your Opinion on that ? how can you choose cheek implants that are right for me ?

    Sophia :: 1 year, 6 months after

95. Sophia,

    The fact that the cheek implants are too small for your face is the primary reason to consider removing and replacing them… That’s not to say that bigger is always better when it comes to cheek implants but certain sizes do, in my opinion, make a face appear soft and feminine.

    I’d have to see a picture of your face, know what type of cheek implant you currently have and the size in order to make further determinations of what would look good in your case. You can e-mail pics to the office staff at drfpalmer1@aol.com

    You can find out the type, style and size of the implant from the plastic surgeon who did the cheek augmentation. If they are silastic, they are easy to remove and replace.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 6 months after

96. Dear Dr. Palmer,

    I had chin augmentation just over 3 weeks ago. It is a silastic implant with 5mm projection. The surgery was done through an oral incision in my mouth. The stitches have not dissolved after 3 weeks either… The result is an improvement to my face and I don’t have any swelling on my face. My problem is that I feel incredible tightness and rigidness under my lower lip and all around my chin. When I smile, I look sad and it’s no longer MY smile. This has been really depressing for me. I’ve gone to see my surgeon twice now and he’s said that there’s no sign of infection and evrerything appears to be healing well. He’s vague and he doesn’t seem to answer my questions about WHAT IS GOING ON INSIDE THAT area. I really hope you can shed some light on this for me. Thank you so much.

    Rav :: 1 year, 6 months after

97. Rav,

    I don’t place chin implants thru the mouth for various reasons, the least of which is increased swelling in the area below the lower lip and the possibility of implant migration into that area. You may want to see the plastic surgeon that di your chin augmentation and have him/her take a look and tell you everything is cool.

    Dr. Francis R Palmer, III

    drfpalmer :: 1 year, 7 months after

98. Thanks Dr. Palmer. I had another query. On the left side of my chin I can feel a harder bump than on the right. I believe this is the implant. The left side also has a feeling of “pulling” and a lot more discomfort than the right. When I trace my finger along the right side of my jaw and chin area it feels smooth and I cannot feel the implant and the “pulling”/tight sensation is a lot less. In your professional opinion, why is this? Thanks.

    Rav :: 1 year, 7 months after

99. PS. That hard bump is actually more on the side of the chin where the implant is tapering I guess.

    Rav :: 1 year, 7 months after

100. Rav,

     Not sure, could be that the one side is healing slower. Consider asking the plastic surgeon that did your chin implant surgery this question.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 7 months after

101. Hi Dr.,

     I wrote before regarding my cheek implants. It’s been 2 months & i’m still not happy with the look and still worried to death about my upper lip. I can smile, it looks and feels forced but I can smile. I’m still having a hard time pronouncing certain words and eating (upper lip feels heavy and still cant pout). Dr said I was one of those rare patients that heal very slowly. He wants me to wait one more month. One more month seems eternal to me because I’ve been hiding from everybody & the people that have seen me keep asking me WHY in the world did I elected to do this if I was beautiful (?) before. Part of me WANTS to believe that all of this will be resolved in a month but ALL of me thinks it will not since I haven’t seen any change in two weeks. Is it reasonable to wait one more month? If I need a second opinion, would you be able to tell me if the implants were too big for me and if I needed them in the first place? (I personally don’t think I needed them because I had fat cheeks but some how got convinced that these were going to improve the look of my under eye circles)
     Please let me know if you can help me make a decision about these implants & what you need to know before scheduling an appointment.
     thank you

     Silvia :: 1 year, 7 months after

102. Silvia,

     Hopefully, the nerves will all come back in your upper lip…they typically do and can improve for a year or two after the cheek augmentation….so don’t despair just yet. This is of course a separate issue of whether the cheek implants are too large for your face or you like the final result.

     Yes, I can evaluate your face and the cheek implants. I’ll need a picture of your face front view before the cheek implant surgery and the type and size of the cheek implants that were used. Example would be silastic implants from Implantech TMSL3. This information can be obtained from the nurse at the plastic surgeon’s office that performed the surgery.

     You can e-mail us the pictures (can include a post op as well of face from front) and the implant info to drfpalmer1@aol.com You then call the office at 310-652-9583 and schedule a phone consultation with me to review my findings and opinion. This is second best, of course, to me seeing you in person which allows me to not only evaluate the cheek implants and your face but let’s me gauge the level of weakness in your upper lip.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 7 months after

103. Hi there Dr. Palmer.

     I am a fellow doctor (Radiologist) who has actually scheduled myself in for surgery in the near future. I have a mid sized silicone chin implant lined up and chin liposuction. I only recently have I learned of the potential complication of bone resorption and wanted to know how much of a potential complication rate there is. My surgeon was planning a submental approach and placement above the periosteum without fixation (screws etc). Also what is the satisfaction rate in terms of cosmesus?

     I am very tempted after reading the high number of unhappy stories out there to stick with lipo alone and stick with my chin of 35 years.

     Thanks in anticipation.

     Regards
     J

     J :: 1 year, 7 months after

104. J,

     You can try the submental lipo and see how much that does…certainly. Here are the basic facts about chin implants.

     1. they are quite safe and reliable…quick surgery and quik recovery if performed thru a submental incision…not intr-oral. I only use silastic implants.

     2. there is a small chance (not sure the %) that will cause erosion of the mental bone….if this happens the implant should be removed. At a recent conference, the latest thinking is that the implant doesn’t erode the bone but rather causes some increased bone formation. Placing the implant above the periostium is thought to decrease that but that’s just theory.

     3. the implant is typically secured by placing it below the periostium and if placed above, in my opinion, is much more likely to shift, move and be seen/felt thru the skin.

     I have done many chin implants for over 20 years and consider them safe and highly effective with very little risk of erosion or shifting if placed directly on the bone.

     Nothing, as you know, in medicine is without risk. I would have a chin implant or do this on a family member…if that helps you place it in perspective.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 7 months after

105. J,

     I did want to add that in my expeience, the vast majority (99%) are thrilled with their chin implants…but other surgeons may have other experiences.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 7 months after

106. Hi Dr. Palmer,

     My name is J and I live in Orlando, Florida. I am turning to you to see if you may know the cause of this problem that I have. I had cheek implants back in 1994 and I had them removed about a couple of months after the surgery. Over the last 14 years my cheeks are still swollen and have never returned back to original, even after removing the implants. My cheeks are sometimes more swollen on some days and less swollen on other days. I do not know what is causing this? And I would like to simply have my original flat cheeks again. I would be willing to fly out to you for consultation so you could look at them, and or possibly a answer to the cause of why my cheeks remain swollen. At the end of each day, my face swells down, then when I wake up the next morning they are swollen again. This has been going on for 14 years! Please help Dr. Palmer… Regards, Jamie.

     J :: 1 year, 7 months after

107. J,

     Wow, this is extremely unusual and I don’t think related to the 2 months that you had the cheek implants in place now still causing issues some 14 years later. I think you should see a good Ear Nose and Throat doctor in your area for a comprehensive work up of your salivary glands including the Parotid glands. I’d look for a medical explanation and rule that out at this point.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 7 months after

108. Just wanted to say thanks very much for your input Dr. Palmer. I have been away hence the late reply, but I didn’t want your input to go unthanked.

     Kind regards

     Justin

     Justin :: 1 year, 7 months after

109. Justin,

     You are welcome…hope it helped.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 7 months after

110. Dr Palmer,

     Do you, with your subperiosteal approach use screws to anchor the prosthesis? Would you recommend fixation for an implant if it is above the periosteum? Thanks

     J

     J :: 1 year, 8 months after

111. J,

     I place chin implants thru an incision below the chin and under the periostium only. In this manner they don’t require srews or other fixation methods nor is there a high degree of bone formation or absortion. Placing the chin implant above the periostium may require srews to fix the implant or it most likely would feel mobile within the soft tissues over the chin. FYI…I’m not aware of any data that shows placement of the chin implant above the periostium is superior to placement below.

     Dr. Francis R Palmer, III

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 8 months after

112. Dr. Palmer,
     I received a chin implant through an oral incision in my mouth 12 years ago. I have never had any problems. However, after reading questions on this blog, I wonder what effect my implant could have on my lower front teeth? Over the years, my lower front teeth seem to be “pushing up” more, weakening and having more soft spots. Could this be a direct result of the implant? I’m worried and not sure if my dental problems are a result of the implant. Thank you for your time.

     Tal :: 1 year, 8 months after

113. Tal,

     You can have your dentist do a panorwx X-Ray of your chin to see if the implant is causing bone erosion.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 8 months after

114. Hello! I just got a chin put in and Im not sure if Im starting at it too much or if I am freaking out too soon, But is it normal for the different sides to heal differently and look differently for awhile? One side it alot more rounded and squared and I can feel that it is still heal and i can feel the foreign object in my chin when i smeak/eat. The other side however has more of a shape to the jaw line, it goes in more when the it come toward the chin. And I feel like it has completely healed, Its not soar and It feels as if nothing at all has even been but in on that side! Please let me knoe if this is normal…I just hope there hasnt been some sort of shift. I dont know how that would happen when I havent really done anything too it.

     Gonz :: 1 year, 8 months after

115. its me again…to describe the rounded side better, It almost feels like theres an air bubble under the impant. or as if my glands swollen. I can feel it when i move my head and chew. NORMAL?

     Gonz :: 1 year, 8 months after

116. One last thing….it feels like my jaw is being pulled to one side.

     Gonz :: 1 year, 8 months after

117. Dr. Palmer,

     I had cheek Augmentation surgery w/ small silicone implants approx. 2.5 weeks ago. The swelling (where the implant was placed & below) is still quite noticeable. The incisions were placed through the upper lip. My main concern is every time I smile…my upper lip seems to turn down somewhat & I cant create a full smile as I did prior to surgery. Is this normal? Also, I feel as if I have trouble forming words (due to my upper lip). I am worried because I have an important business event to attend in about one month & hope this will mostly be resolved. Any advice would be greatly appreciated. I can also send you before & after photos. Your website has benn a blessing to me & to other concerned patients.

     Thank you,

     Lisa

     Lisa :: 1 year, 8 months after

118. Gonz,

     In my hands, Chin Augmentation with Chin Implants heal very quickly. If you are having these sensations and symptoms, you should see the plastic surgeon that did the Chin Augmentation and ask for his/her assessment.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 8 months after

119. Lisa,

     This is quite common. The Cheek Implant sits atop the muscle that lifts the upper lip and the resistence is most likely what you’re feeling. This slowly resolves over 1-3 months. I have my Cheek Implant patients use their mouth as normal during the post op period. If it persists or you are very concerned something is wrong, go see the plastic surgeon that did your Cheek Augmentation.

     I do many of these surgeries and have for over 20 years. I also have the patients sleep on a U-shaped pillow for 1 month after the Cheek Augmentation woith implants to avoid sleeping on the implant and possible shifting.

     You can read more about Cheek Augmentation here:
     http://www.drfpalmer.com/CheekImplants.html

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 8 months after

120. Hi Dr. Palmer,

     I am a 34 year old male with relatively flat cheeks that have hollowed with age. I’m also hollow in the lower eyelid region, in part due to a lower blepharoplasty I had several years ago. I consulted several surgeons. Most recommended fat grafting to the lower eyelid region, but I received a very diverse set of recommendations regarding the cheek area. One surgeon recommended medium cheek implants, another large or XL implants, while two other surgeons recommended fat grafting and told me to stay away from the cheek implants.

     Below are a bunch of general questions. I know I’ve asked a lot so please don’t hesitate to answer as few or as many as you like. Thank you in advance!

     - In general, when do you recommend fat grafting to the cheek vs. an implant?
     - Do cheek implants make hollowing under the lower eyelid look worse?
     - Does the outline of the cheek implant become visible or does the implant’s projection look unnatural as our faces hollow with age?
     - Does placing fat into a flat cheek further weigh down the soft tissue and promote cheek pad descent or jowling?
     - What has been your experience regarding the longevity of fat grafting to the cheek and lower eyelid? Can I expect the graft to last 5-10 years or beyond?
     - Regarding lower eyelid hollowing, do you ever place tear trough or orbital rim implants? I’m curious as to why these implants aren’t promoted more as a permanent solution to lower eyelid hollowing or bony insufficiency in this area.

     Thanks again.

     - Dave

     Dave :: 1 year, 8 months after

121. Dave,

     Here goes:

     In general, when do you recommend fat grafting to the cheek vs. an implant?
     Dave, Fat grafting is not predictable, cheek implants are. I never use fat grafting and always choose an implant over fat. I know what I get with an implant…can’t say that about using fat.

     - Do cheek implants make hollowing under the lower eyelid look worse?
     They can if the cheek implant is too thick…this will depend on the aesthetic skill of the plastic surgeon and his expertise using cheek implants.

     - Does the outline of the cheek implant become visible or does the implant’s projection look unnatural as our faces hollow with age?

     Cheek implant is not visible…will not cause hollowing.

     - Does placing fat into a flat cheek further weigh down the soft tissue and promote cheek pad descent or jowling?

     Yes, logically the added weight of the fat will be effected by the pull of gravity.

     - What has been your experience regarding the longevity of fat grafting to the cheek and lower eyelid? Can I expect the graft to last 5-10 years or beyond?

     No, fat is dead tissue that may or may not live and could dissolve in an uneven, lumpy fashion. I don’t recommend this course of action for my patients.

     - Regarding lower eyelid hollowing, do you ever place tear trough or orbital rim implants? I’m curious as to why these implants aren’t promoted more as a permanent solution to lower eyelid hollowing or bony insufficiency in this area.

     No, these are not popular because they have problems. the skin of the lower eyelid is too thin to hide any implant or fat grafting.

     FYI, read my Palmer Beauty principles. In my aesthetic opinion, large or XL cheeks will make the face look feminine…not apprpriate for men.

     You can send photos to drfpalmer1@aol.com or call 310-652-9583 for a consultation and another opinion.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 8 months after

122. Dr. Palmer—wanted to know what your experience has been with using Radiesse for the jaw angles, to create square, masculine look, like Brad Pitt.

     I heard you prefer Radiesse for this over silastic mandibular jaw implants. Why ?

     Vincent :: 1 year, 8 months after

123. Vincent,

     Yes, I have done many patients usinf radiesse to shape the jawline, jaw angle, chheks and chin. The jaw implants are quite problematic and I don’t offer them for that reason, so in the jaw area, Radiesse offers a great alternative.

     Dr. Francis Palmer

     drfpalmer :: 1 year, 9 months after

124. Hi Dr. Palmer,

     Thank you for your reply. I reviewed the cheek implant section of your web site. It seems like choosing the proper size cheek implant is really critical to achieving a good outcome.

     - What happens if I’m unhappy with the size of the implant? Is it easier for you to remove the smaller implant and replace it with a larger one or vice versa?

     - I’m quite anxious about getting cheek implants and may opt for the temporarily filler Radiesse instead. How long would one typically have to wait to get cheek implants following a Radiesse injection?

     OK. Thanks again. I’ll try to take some close up photos and email them to you.

     - Dave

     Dave :: 1 year, 9 months after

125. Dave,

     Yes, the proper size and shape of the cheek implant is key to the correct aesthetic look. I use 1 shape and several sizes for men and women as these give the best results and make people look great without being over done…a real no, no with cheek implants. On the website, I list many types and styles of cheek implants as educational reference, not that I use them but for the reader to see the huge variation that exists in style, size and shape of cheek implants. Many of these, I believe to be aesthetically incorrect.

     You will need to trust the aesthetic judgement of the plastic surgeon for your cheek implants. You can e-mail the office photos of your face from front view for evaluation.. drfpalmer1@aol.com

     Radiesse is a great way to ease yourself into facial sculpting but placement and the amount of Radiesse, like selecting the proper cheek implant, is key for the right look. I typically use 1 syringe for each cheek, the Radiesse injections are done as an office visit and take about 5 minutes. 2 days later, you have great cheeks. Radiesse lasts 12 to 18 months.

     It is very rare for me to remove cheek impants that I have placed…that’s because we spend soo much time discussing the proper size and shape with our patients. You may want to do this instead of guessinng and then planning on an exchange of the cheek implants if you’re not happy.

     I have performed many cheek augmentations over the past 20 years with cheek implants and now using radiesse injections as well. You need a plastic surgeon with experience in this area and you’ll need to have a consultation to figure out the proper size and shape of the cheek implants, so you get it right the first time.

     You can call the office at 310-652-9583 if you wish to schedule a consultation for cheek augmentation with cheek implants or with radiesse Injections.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 9 months after

126. Hi Doctor Palmer
     I am 44 year old male, a little over 5 years ago I had a small chin implant and some lipo done. The implant was placed via an incision inside my mouth.
     While I feel the placement of the implant was centered properly, it seems the wings along the jawbone never seemed right. on my left side it feels as though it tucks under the jaw, while on the right it runs along the side. I now more often than not experience pain in the area that the nerve passes through my jaw on my right, and pain on the left where I feel it has tucked under my jaw.
     Is it possible that the implant can be pressing against this nerve and or the poor placement of the wings of the implant have caused some damage that I should be concerned about.
     What action should I take if any?
     Chris

     Chris :: 1 year, 10 months after

127. Hey Chris,

     That’s exactly what it sounds like and yes, the implant may be impinging on the nerve. Unlikely it will cause damage to the nerve but you may want to visit the plastic and cosmetic surgeon that placed the chin implant and get their opinion. Obviously you can remove the chin implant but also perhaps one that’s not so long might avoid the nerve.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 10 months after

128. Dr. Palmer,

     Two years ago I had a chin implant placed that I’m not happy with. I feel that the implant is off center and is not the correct size/shape/fit for my face. Recently I have been considering getting this implant removed and replaced with a different shaped implant. I was just wondering if there would need to be time between these two surgeries (or if it could be done in one shot) and what your general thoughts are on removing and replacing an implant. Thanks!

     Jenna :: 1 year, 10 months after

129. Jenna,

     I often can take out the implant and place the new one without issues. It helps if you have the specifics of the chin implant…company, catalog number and size. You can e-mail us pictures at drfpalmer1@aol.com

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 10 months after

130. Hi there Dr Palmer,

     My plastic surgeon put in a chin implant 3 months ago. The anterior part is above the periosteum with the wings on each side beneath the periosteum on each side to fix it in place. On day 2 ( when I as seen for follow up) and immediately after the procedure I could feel the left side was higher than the left but was reassured by the surgeon that it was in the correct place. now that the swelling has gone I know for certain on the left it is a good 8mm superior to the jaw line whilst on the right is exactly where it should be (on the jawline) giving my chin a slight angle.

     The surgeon has a slightly patronising attitude in the past with attempts at false reassurance and as a medical specialist I am somewhat hesitant to be too hard on him but find it hard that he would fail to admit to error. I have been told I have uneven jaw line. well Ok maybe I do, but surely even if that were true the implant should still be on the jawline.
     Should a revision be done would it would be done using the same impant?
     If it isn’t done right the first time can there be any assurance that the second effort will be any better given the operative field is no longer a virgin one?
     Thirdly I wanted to know in regards to the preop mark up, could an error have been made, as the line on my chin was off centre or is it standard to line up the implant with the patients nose/lip etc… or that an individual choice?

     I am going to see the surgeon when he returns from a conference in the US so was hoping for some input prior.

     Thanks in advance
     J

     J :: 1 year, 11 months after

131. J,

     Let’s take these in order.

     1. A revision Chin Augmentation could certainly be done and you should be the judge of whether, or not that happens. If you’re really not happy with the chin implant, you should consider re-positioning or replacing the implant. You didn’t tell me several key elements….what style and size is the implant, was the incision under the chin or inside the mouth and from what type of material is the implant made.

     2. I place all cheek and chin implants below the periosteum but other plastic and cosmetic surgeons place all or part above as in your case. It is not unusual for any part of the chin implant to move a mm or so as the pocket is larger than the implant. It is a bit unusual for it to be 8mm shifted. Revisions whether chin or any implant are more difficult…in this particular, case the edge is 8mm above where you indicate the jaw line edge is…that means during dissection there will be even more room for the implant edge to move. I fix the implants externally with steri strips and you might need to have these on for 2 weeks straight. Even then, I’d make no promises that it wouldn’t shift.

     3. Really, who knows. Pre-op markings are individualized by each surgen based on what he wants the marks to tell him/her.

     Bottom line, if you hate it…fix it but as you can imagine…life and plastic surgery hold no guarantees.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 11 months after

132. Dr Palmer,

     Thanks for the info.

     Sorry I did cut out a few key details.

     The incision was a below chin skin incision with a medium sized silicon implant put in place.

     I don’t believe the implant has ever shifted. It felt and looked uneven from day 1- left side higher than right- and now I have a chin that looks like my right side is lower. Cosmetically it is subtle to others, other than myself. My wife says I look better etc but I am concerned about potential long term complications as the wing on the left is overlying the roots of the lower teeth/inferior alveolar nerve canal etc. Secondly I have very palpable ridge on the left as the implant is not sitting on the curve of the jawline, whereas on the right i can barely feel it at all. I can live with the unevenness although when you spend 10000+ I expect a good job if not perfect!! I didn’t expect the degree of unevenness.

     Again thank you for your time and input. I guess as you say, even with revision, it may be skew or later move.

     I think I will bide my time and discuss things with the surgeon before making a decision.

     Thanks
     J

     J :: 1 year, 11 months after

133. J,

     Always a wise decision. Your issue of nerve impingement has merit especially if you have any Sx’s at this point. Only sure way would be to remove the implant, leave it out for 3 months and then replace it after the tissues have healed allowing a new pocket to be elevated for the edges of the implant.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 11 months after

134. Hi Doctor ,

     i had a nose job and a chin implant last year in october. Both the surgeries turned out to be disasters. My nose looks very small now , its become a pug nose now ,looks very different from what I had , also chin implant which I got removed was way too big ( I had an accident it came out further ),even after removal it looks big unlike what it used to look .I have also lost sensation in my chin.

     My questions :

     Will ever get my original chin back ?

     How can I improve my nose its become small, pug ,very different from my original ohin ?

     Will I ever get my sensation back , Doctor says it will , I dont know ?

     rahul :: 1 year, 11 months after

135. Rahul,

     Let’s talk about the Rhinoplasty first. You should have options to build up your nose with a revision Rhinoplasty. I’d need to see you in person or photos of your nose to make more specific recommendations. You can e-mail pictures to drfpalmer1@aol.com and you can schedule a phone consult to discuss my findings and recommendations by calling the office at 310-652-9583. You also could be seen in consultation at our office here in Beverly Hills.

     I’m confused why your chin isn’t back to its original size after the chin implant was removed. It should have done so. Sensation should return unless the nerve was damaged when the implant was placed. Usually the sensation comes back within the first year after the Chin Augmentation.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 11 months after

136. What is the chance of sagging chin skin after 6 mos of small implant with wings on a 40 year old woman? Should my dr. offer to “tuck” the skin if I need that? Should I ask him to do that? What if he just tells me no? (I don’t have much trust in him anymore - he is refusing to fix my crooked implant telling me it is too risky and that I am “too picky” thank you M

     MJ :: 1 year, 11 months after

137. MJ,

     At 40, if you take the chin implant out, you may have some excess skin…there’s just no way to tell for sure or to know how much. Not sure what to tell you about the other issues…you’ll have to decide what to do about those.

     Dr. Francis R Palmer, III

     drfpalmer :: 1 year, 11 months after

138. hi doctor …
     after i removed my chin implant 1 month back….my skin is still loose and sagging , what can i do about it …will it ever go back inside….or do i need to get it tucked …what do u suggest , becase it has spoiled my profile a lot…

     regards

     rahul

     rahul :: 1 year, 12 months after

139. Rahul,

     The skin may shrink. What did the plastic and cosmetic surgeon say that placed and then removed the chin implant?I’d give it 3-4 months and see what happens. The skin can always be removed with a small incision under the chin.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years after

140. I would like to contact Dr. Palmer about his cost to remove cheek implants and chin. I would be interested in replacing with cadaver bone. I do not like the size of cheek bone implants. Too big and chin implant impedes me from being able to smile. I would like costs on just to remove implants. They are silicon put in through the mouth. I would like the cost to replace these with smaller cadavers. I cant move my face and it has been several years. I want something more natural for my body and for my look. I have not had problems with swelling or scar tissue so far, but am willing to risk a little to get the silicon out and smile again.

     Nina :: 2 years after

141. Nina,

     I will forward your request to my staff who will respond to you by e-mail. You can contact them at drfpalmer1@aol.com or 310-652-9583.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years after

142. Dr. Palmer, I had a silicone chin implant removed 2 years ago (through the mouth). It was initially placed too high and was bothering my speech, my teeth, and was causing me constant pain.

     To make the long story short, after the removal, I have a constant pull-down feeling, especially when it’s called outside, my entire chin pad goes “which-y” when I smile, overall, there is no day without pain, pulling etc. The droopy chin pad bothers me a lot, but the pain and pulling are worse. I’d love to fix my chin somehow, but am a little scared not to make it worse.

     I live in San Diego, and can easily travel up to LA. Can you help me, and how do I schedule a consult?

     It’s bad the way it is

     pauline :: 2 years after

143. Pauline,

     You can contact my office by e-mail at drfpalmer1@aol.com Send an e-mail with photos or you can call the office at 310-652-9583 to schedule a consultation. I’ll take a look at your chin and see if I can’t come up with some solutions.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years after

144. I was quite thankful to find this thread. I am a 41 yr. old woman who had a chin implant along w/rhino about a year ago and just in last few months noticed an increase in marionette line particularly on right side. However, P.S. recommended lip implants(permalip-to be exact) to help the symmetry in my face. I now have this big facial fold almost a holllow between chin and lips on right side. it’s very bizarre and I am freaking out. The rest of my face is fine and now I don’t know what to do. Might I need a lip lift too now?

     kim :: 2 years, 1 month after

145. Hi Dr.:

     Thank you for your time!

     I had a chin implant (through the mouth) about 2 years ago. It seems solid, no motion, only I’ve noticed that the wings are still wobbly. (Although the implant, as a whole, seems very firmly rooted.)

     My doctor said the wings would eventually become less wiggly, but I have to confess I do poke at the wings from time to time (in a stupid nervous reaction), to see if they’ve become more grounded.

     (I wasn’t sure whether my doctor’s reasurance that the wings would eventually become less flexible was accurate, or he was just trying to ease my mind, and it could still become an issue.)

     I guess my question is: Even though it’s been 2 years, if I leave the wings alone, should they eventually become more stable somehow?

     Thanks for any advice,
     P

     Paul :: 2 years, 1 month after

146. Kim,

     Not sure. I can’t visualize what you are describing. Marrionette lines are from Jowls and typically are treated with soft tissue fillers like Perlane or Juvederm or some form of face lift procedure. Not sure how fuller lips would have an effect. You may want to e-mail us pictures of your face to drfpalmer1@aol.com you can also schedule a phone consult to discuss my findings and recommendations at 310-652-9583.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 1 month after

147. Paul,

     Probably not after 2 years. The ends of the chin implant should be under the bony covering but if you were touching and moving them from early post chin implantation until 2 years postop, you may have created a larger pocket for the implant and it will continue to move. Don’t touch it for 2 months and see what happens.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 1 month after

148. Hi Dr.

     Thank you so much. I’ll leave it alone from here on out. (Mostly it isn’t even noticeable at all, unless I “check”.)

     Finally, is it an issue, or something I need to be concerned about?

     Paul :: 2 years, 1 month after

149. Hello Dr. Palmer. Wished I knew about you before I had my chin implant. Had it put in about 5 days ago through the chin. It is the rap around kind. Looks way too masculine. It’s just too long and too perfectly rounded. It doen’t look natural. I have iced it for 5 days now and I believe that the vast majority of the swelling has gone down.

     I have not given up on implants completly. I would like it replaced with a smaller less rounded implant. My question is:

     1. How long do I need to wait before replacing the current implant with a smaller one?

     2. Can I remove the current implant and replace it with a new implant at the same time?

     3. My face is naturally kind of long. How can I avoid this long look even with a smaller implant?

     I just want a more defined chin. Before the chin implant I had been putting a filler in my chin and loved the results. I would use two suringes of Juvederm and stll felt like I could use a third suringe. Help!!!

     Thanks much,

     Charlie

     Charlie :: 2 years, 1 month after

150. p.s. Also, to clarify, it’s just the last couple of centimeters of the “wings” that move, not the whole implant

     Paul :: 2 years, 1 month after

151. Charlie,

     It’s really too soon to make that rash of a decision. I do quite a few cheek and chin implants. The chin implants heal very quickly…most healing within 1 month. I suggest that you wait 1 month. If at that time you still hate the implant, send me a picture of your face or see me in person. Yes, the implant is very easy to take out and replace with another implant if it’s a solid silicone (silastic) implant and not medpore or gortex. If the face appears too long, the chin implant may be placed inferiorly and not in front of the chin…where it’s more aesthetically correct, in my humble opinion. Pictures to drfpalmer1@aol.com and 310-652-9583 to schedule a consultation. Don’t worry, it’s easy to deal with if it does come down to that.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 1 month after

152. Dear Dr.,

     I see several chin implant questions regarding smiling. I had a tapered implant 8 days ago (size small was decided during my consultation, however I have yet to go to my follow-up and hear if that is what was actually used).

     I used to have a huge, toothy beautiful smile. I’m very panicked that it will never return. My doctor is very reputable and clearly a DDS, so I am surprised this tooth-related issue wasn’t brought up at any point (this also makes me think/hope it’s temporary!).

     At this point (day 8 post-op), I have no more bruises, no more numbness, just slight tightness…is the tightness impeding my smile? Is there anything I can do to speed up this recovery? facial exercises? massaging the area?

     Your blog is outstanding!
     AB

     AB :: 2 years, 1 month after

153. I didn’t mean “clearly a DDS” - but is ALSO a DDS in addition to plastic surgeon, with a primary focus on chin contouring. Thanks again for your help!

     AB :: 2 years, 1 month after

154. AB,

     I do many, many chin and cheek implants for augmentation and have done so for almost 20 years. A restricted smile after a chin implant procedure is about 100% likely to happen and I hope your plastic and cosmetic surgeon mentioned this to you before your chin augmentation. This typically resolves over several months after the chin implant surgery but could take a year or so before your smile feels completely normal. There is always a very small chance that the nerve was injured during the surgery in which case your smile would not completely return. You should ask the plastic and cosmetic surgeon that did your chin implant procedure and get some reassurrance on this issue.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 1 month after

155. Dear Dr.,

     I just learned on your site that MEDPOR cheek implants cannot be removed. My surgery was on 05/29/08 and MEDPOR Surgical Implants Super Petite Malar Design were used. Unfortunately, now, after the swelling is gone, I realize that the right implant sits higher than the left and it can be felt by placing my hands over my cheeks. It also gives my face a slightly uneven look.

     Prior to surgery I was not given a choice of implant type by my surgeon and also not informed about the pros and cons of the MEDPOR implant he used.

     How can this be fixed if they are not removable?

     Thanks for your advice in this case.

     Barbara

     Barbara :: 2 years, 1 month after

156. Barbara,

     I was told by the company expert that Medpore becomes part of the ceek bone at 4-6 months. You may consider asking your plastic and cosmetic surgeon to remove these before they become integrated into your cheek bone and become a permanent issue. You can contact the Medpore company for further information. It is my personal opinion that I prefer Silastic Cheek and Chin Implants for cheek and chin augmentation because these cheek and chin implants can be removed. Your cheek implants may be screwed in place, so be sure to ask your plastic surgeon about that as well.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 1 month after

157. Hi Dr. Palmer,

     I noticed that most patients that had cheek implants also had better jawline and less squarish faces. Is it because of the lifting done by the cheek implants or they had jaw contouring also?

     If I do decide to have cheek implants, should I also expect a similar result?

     I have flat cheekbones that makes my face look wide and gives an illusion of a not too nice jawline.

     Christy :: 2 years, 2 months after

158. Dr. Palmer,

     Thanks for the advice! I went to my one-week post-op appt, and everything is on track. Now all I have to do is wait for the remaining swelling to go down.

     Is there anything I can do to speed this up? I am starting graduate school in two weeks, so 5 weeks post-op (which means lots of introductions and photographs). I could be way off here, but are localized steroid shots possible? If not, what do you recommend to cosmetically expedite my healing. I KNOW time is the best remedy, but if I were a celebrity with an event coming up, what could I do in this situation to look my absolute best? (I know, having plastic surgery 5 weeks before was not the wisest plan, but it was the only time I could fit it in!).

     As you and several others have noted, I realize 6 months post-op will give me the most accurate “read” on my new chin — and the swelling subsides more and more each day — but I want to look the best I can in 2 weeks…is there anything I can do?

     Thanks,
     AB

     AB :: 2 years, 2 months after

159. AB,

     If you were one of my Beverly Hills socialites or LA Celebrity clients, I wouldn’t have done your Chin Augmentation with a chin implant 2 weeks before filming, red carpet or another big event. All you can do is ice if your plastic and cosmetic surgeon that did your Chin Augmentation gives you the green light to do so. You might also ask the plastic and cosmetic surgeon if avoiding strenuous activity may help sped up the healing process.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

160. Christy,

     No, Chhek Augmentation with Cheek Implants will not lift, change or in anyway effect the jawline. The jawline is a separate aesthetic unit and if you’re unhappy with yours,this would require q separate procedure or manipulation.

     Depending on your age and the specific issue it might be a matter of facial and neck micro-liposuction, chin augmentation with a chin implant or something to effect the shape of the jawline. Although jaw implants do exist, most plastic and cosmetic surgeons here in Beverly Hills and elswewhere feel that the associated complications with these jaw implants far outweigh their benefits and as such do not use them. I use Radiesse Injections, a soft tissue filler that last 12-18 months, to shape the jawline. I have found Radiesse to be safe and highly effective for this purpose.

     Please remember, Cheek Augmentation using the proper aesthetically correct Cheek Implants can transform the face making it look (in your case) more feminine but it will not change any other facial feature. Do your research and be very careful choosing the right type, shape and sized Cheek Implant. This is definitely a case of more is not better….too large of a Cheek Implant doesn’t make the face look better, it makes the face look freakish. I believe in subtle but highly effective Cheek Augmentation and most often combine that with NLF micro-liposuction which allows the anterior trigger point of the Cheek to appear.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

161. Hi Dr. Palmer,
     I was wondering if you have ever performed premaxillary augmentation using bat-shaped implants, or if you have a complete understanding of this procedure.

     If so, I have a number of questions involving the results of this procedure.

     1. My biggest concern for the result of this procedure is that my upper lip might droop down low and cover my upper teeth. What would the surgeon need to do in order to prevent this from happening (because this is very possible)?

     2. From what I understand, this implant is inserted under the nose base. Am I right?

     3. Is this a procedure that many surgeons can perform? Is it a common one?

     4. Would I be able to get this procedure as a stand-alone operation rather than an adjunct procedure to augmentation rhinoplasty? I mean I’d like to have premaxillary augmentation without changing my nose.

     5. As a general surgery question, what would happen or what would I do if I get an infection after the implant is inserted or years after the implant is inside?

     Thank you for your time.

     Liam :: 2 years, 2 months after

162. Liam,

     I am aware of but not a big fan of this type of implant. Typically this is used for columellar retraction but I have found other techniques more effective. I personally feel that this implants are to large for that area of the nose. Best way to avoid the issues you mentuion is to have another consult with a plastic and cosmetic surgeon and get another opinion about the issue. You can send photos for evaluation to drfpalmer1@aol.com or you can contact the office at 310-652-9583 for futher information.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

163. Thanks for the response Dr. Palmer. What are the other techniques that you mentioned?
     My goal is to fill in the depressions on either side of the nose and make that part slightly rounder by raising it up a bit (which, I assume, will also make the face slightly more convex).

     Liam :: 2 years, 2 months after

164. Liam,

     I’d have to see pics of your face or you in person to make specific recommendations. Fillers and cartilage grafts as well as adjustments of the columella and anterior nasal septum will all effect this area. You can e-mail photos to drfpalmer1@aol.com or call the office at 310-652-9583 for further info.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

165. Dr. Palmer,

     I just had cheek implants 6 days ago and now my smile is totally ruined. When I smile my upper teeth are not visible and I know this is caused by swelling and I know I have to be patient, but have you ever experienced or heard of a case in which a smile was forever ruined because of the implant?

     And another thing is my left cheek is more swollen than the right and I can “feel” the implant in the left whereas I cannot the one in the right. Is this normal? Or could it mean that the left one is infected? I am so scared about my smile and I feel I look like a chipmunk but I do realize its only been 6 days.

     Could you please let me know about the smile and infection issue? Thanks so much and I wish I knew about you prior to my surgery since you are so knowledgable!

     Caprice :: 2 years, 2 months after

166. Another thing I forgot to mention, is that the left one that I “think” is infected, makes this weird squishy noise when I touch it, almost like little air bubbles popping, and the right one doesnt do that. Have you ever heard of that and should I be worried?

     Caprice :: 2 years, 2 months after

167. Caprice,

     You may want to see the plastic surgeon that did your Rhinoplasty, another plastic and cosmetic surgeon that is seeing his emergency cases while he is away or another plastic and cosmetic surgeon to rule out an infection. Better safe than sorry.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

168. Caprice,

     Sorry, I read this after the last post and thought you were post surgical after a Rhinoplasty. I understand now that you had cheek augmentation with cheek implants. It’s very common to have a decreased smile after cheek implants and this is due to the implant itself as well as he swelling after the cheek augmentation. The air sound is no big deal and typically is from trapped air during the cheek implant placement. The air will be absorbed by the tissues and no, it won’t go into your arteries and cause your heart to have problems…that’s a different issue unrelated to this.

     As always, I suggest that you discuss your fears and concerns about these issues with the plastic and cosmetic surgeon that did your cheek implants.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

169. What can be done if one is unhappy with a sliding genioplasty (your own bone chiselled out and advanced)? I had this done several years ago in connection with orthonagic surgery. I had the upper jaw widened, the lower jaw advanced, and the sliding genioplasty. My lower face, particularly the lower lip and chin, lost their feeling (permanent nerve damage). My chin looks puffy and asymettrical and I have some degree of lip drop/drooping with is more pronounced on the right side. The incision was done in the mouth. Also, the “button” of bone can be seen somewhat through the skin. In short, it was a lousy job, I feel. I substitute teach, and kids sometimes ask “what’s wrong with your chin?” so it must be obvious to other people. It looks worse now that my cheeks are descending and I have marionette lines, and the corners of my mouth turn down in repose, like a permanent frown, and I’m not sure if it’s age-related or nerve damage or both. I look quite the sight when I see photos. My chin also looks a little bit rippled, and feels “heavy”. If it were a silicone implant, I assume it would be easier to remove. But since the genioplasty is wired bone (and now part of the bone underneath is missing), what can be done? How about the nerve damage, and the possibility the chin muscle is messed up from the genioplasty? I don’t know what it would cost to have it fixed, and I might want other surgery to correct the sagging cheeks, but is anything even possible to improve it?

     Mary C. :: 2 years, 2 months after

170. Mary,

     This is the main reason I don’t advocate sliding genioplasties and aggressive orthognatic surgery procedures.
     The nerve damage is most likely permanent although improvement for up to 2 years is always possible.

     The cheeks, nasolabial folds and marrionette lines can be improved and should be your main focus at this point. I’d have to see you or pictures of your face to make further recommendations but Radiesse/Perlane injections NLF micro-lipo or cheek implants are all possibilities. You could e-mail us photos at drfpalmer1@aol.com or call 310-652-9583 to schedule a consultation.

     Now, the chin area. It sounds like there is some tissue loss between the bone and the skin of your chin which would account for the rippling noted there. I’d have to see and feel the chin to see the best way to proceed but there should be something that could be done to improve the look of the chin.

     Dr Francis R Palmer, III

     drfpalmer :: 2 years, 2 months after

171. Dr. Palmer,

     Hi, I had cheek implants about a month ago, they were silicone, and size medium, (I dont know off the top of my head the brand) but its been about a month and they have made my eyes get this sunkern hollow look and just seemed to have made my face wider and I look like one of those “overdone fluffy cheek chipmunks.” I also took some Medrol 6 day course for the swelling, and even after the swelling went down I waws horrified at the look of my new face. I totally look like I had plastic surgery done and the area above my top lip seems to be puffed and when I smile, I look like a skeleton. As you can see I am totally dissatisified, and never expected these changes to take place or else I would not have elected to proceed with surgery.

     Well I want to know what is the SOONEST I can have them removed, if its been 1 month so far. I am 23 healthy female, and want to know will my face return back to normal (meaning the sunken eye look will go away and my smile will come back) after I get them removed? Or should I expect a totally different face once again?

     I am so depressed and wish I never did it and thats why I dont want too much time to go by, because I dont want any visible scar tissue and sagging skin after removal.

     I feel the sunken eye look is because the skin is being stretched over the new cheek bone and Id rather not jeopordize my eye look for more defined cheekbones.

     Please help me with your knowledgable and experinced responses so I can calm my fears.

     Also what is the SOONEST you can have an implant removed so that my fae could go back to the way it looked last month prior to surgery!

     Thanks so much Dr. P!!!

     Nancy :: 2 years, 3 months after

172. I am male, 30 Middle Easterner

     Few Questions:
     1. Can cheek implants reduce the dark circles under my eyes? Can they be placed high enough to emphasise the angles of my cheekbones?

     2. Can Chin implants be positioned under the chin to lenghten the overall appearance of my face?

     3. During rhinoplasty, can the upper lip be adjusted? Currently when i smile you can barely see my teeth, and when you doo the upper lip is not straight due to my nose.

     4. Can Rhinoplasty, Chin Implants, Cheek Implants, and Jaw implants all be done during one procedure?

     5. Do you use the Implantech products? Do you carry many sizers? Do you use digital imaging and if so is it an accurate way to guess what implants and rhinoplasty will look like, or is it a tool to address problem ideas?

     6. Do men get lower lip implants?

     FB :: 2 years, 3 months after

173. Nancy,

     OK, let’s take a deep breath together.

     1. If you really hate the way the cheek implants make you look you can have them out anytime after 1 month, which is now.

     2. At 23, there’s very little risk, in my opinion, of having stretched and therefore extra skin on your face after removing the cheek implants.

     3. Now, let’s talk about whether or not you want the cheek implants out…and anything I say should not be mistaken as a criticism oy your plastic and cosmetic surgeon or yourself. It just is what it is. From what you are describing, the thickness of the cheek implants may be 4, 5 or even 6 mm’s and I typically use 3 or 4mm thick cheek implants that are large , not medium. This will not cause deep set eyes because the implant isn’t thick enough for this to occur. I think you may want to get another opinion regarding your face and whether or not these implants will make you more attractive. It would be a shame to remove them if all you’re experiencing is post op swelling.

     You can send photos to my staff at drfpalmer1@aol.com and schedule a consult or phone consult to discuss this further if you wish. You should discuss this with the plastic and cosmetic surgeon that did your cheek implants, cheek augmentation and decide if you want to see another plastic and cosmetic surgeon for another opinion. After all, it is your face and at the end of the day, your decision. You should find out the brand of cheek implant and the exact size designation like medium 5 mm.

     Hope this helps.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 3 months after

174. FB,

     I want to say from the outset that you should be seen in consultation because adjusting the face with cheek, chin and jaw implants can dramatically effect your appearance if they are done correctly…and it’s too much to discuss in a blog where I can’t even see what your face looks like. OK, now, I’ll try and give you some general answers.

     1. Cheek implants typically are placed no higher than 4mm’s below the inferior orbital rim (eye socket) if placed higher they will distort the shape of the eye. Dark circles under the eye are from shadows or pigment and are dealt with in other ways.

     2. Yes, properly placed, and sized cheek implants will give a male face a more angular, chiesled, sculpted look…but beware, the wrong size and/or shape can be a disaster. You need a plastic and cosmetic surgeon with lots of experience. I do many facial (cheek and chin) implants and have for almost 20 years.

     3. Yes they can be done at the same time. Cheek implants typically take me less than 1 hour and 1/2 an hour to place chin implants.

     4. NO,chin implants should not be placed below the chin bone in an attempt to elongate the face….this will result in a ridge being seen below your chin and will make your face look odd.

     5. Rhinoplasty OK…I’d have to see your upper lip to make comments about lifting or correcting that.

     6. Yes, I’ve done many lower lip augmentations on men and women alike. Everybody looks better with fuller lips. I use Alloderm which, in my opinion, is the gold standard for lip augmentation.

     7. Jaw implants are extremely problematic..erode bone, have to be screwed in, damage teeth roots and on and on. There are much easier ways to make the jaw look prominent and flared. I inject Radiesse that lasts 12-18 months but is an easy office procedure to repeat and has none of those nasty complications.

     8. No, I have it but hate computer imaging…and as such never use it. What a waste of money. The software allows for un-natural and unacheivable tissue manipulation by anyone that can run the software….but the real question is can they do anything similar to you in the operating room. Better to see examples or before and after photos of patients that have had similar surgeries.

     Wow…that was a bunce of info.

     You can e-mail my staff pictures of your face at drfpalmer1@aol.com call for a consult or phone consult to discuss my evaluation and recommendations based on your photos at 310-652-9583.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 3 months after

175. Dr.Palmer:
     Our daughter had a large silicone anatomic chin implant placed through the mouth on July 10,’08, almost 3 mo. ago.
     It was to be a 6mm projection, but looks like it is projecting more than that. Could it still be swollen?
     Also she has asymmetry on the side of her mouth, especially evident when she talks. Is this something we need to be concerned about?
     Thank you very much for your reply.
     Terry

     William :: 2 years, 3 months after

176. William,

     Yes, it copuld still be swollen after a chin implant but that’s a bit unusual after this many months. It maybe the size (projection) of the chin implant…6 mm’s is quite thick.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 4 months after

177. Dr. Palmer:
     You say a 6mm projection chin implant is quite thick. Is there a particular projection that you prefer or use? What is the most common size used?
     Thank you for your reply.
     William

     William :: 2 years, 4 months after

178. William,

     4 to 5 mm’s for chin implants and augmentation but that’s my opinion.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 4 months after

179. Dr. Palmer:
     What is the recovery time for removal of a large extended silicone chin implant that was placed through the mouth? Is there much pain involved?
     Thanks so much for your reply.
     William

     William :: 2 years, 4 months after

180. William,
     I would not remove the chin implant through an incision in the mouth as this disrupts the muscle and may set you up for chin muscle ptosis later in life. I use a small incision under the chin and the implant is typically very easy for me to remove.
     Steri strips are placed across the skin of the chin that can be removed 5 days later. There shouldn’t be any pain and the recovery should be very swift. I’d say some minor swelling for a few days. It’s much less invasive taking a chin implant out than its original placement.

     You can contact my office staff at drfpalmer1@aol.com for further information.

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 4 months after

181. Dr. Palmer
     I am having sx on Thursday 10/31/08. My doctor will be using a small with wings. Im worried about the wings. My face is small. Are there any websites that have examples of sx with different sizes +/- wings. I just do not know what to expect. Thanks, Kim

     kim :: 2 years, 5 months after

182. Sorry, I am 36 years old and also getting rhinoplasty. He is using a gortex implant. I don’t know what size mm wise.
     thanks, kim

     kim :: 2 years, 5 months after

183. Kim,

     I’m personally not a fan of gortex implants but you should have had all of your questions and concerns addressed by now by the plastic and cosmetic surgeon that’s doing your Rhinoplasty and chin augmentation. If you’re not sure what to expect…why are you having surgery?

     Dr. Francis R Palmer, III

     drfpalmer :: 2 years, 5 months after

184. Hi Doctor Palmer:

     Almost 2 years after getting my chin implant, I noticed the “wing” was a little loose on one side. The entire implant does not shift, but the left wing is noticeably “bendable.”

     I started to palpate the wing to see how flexible it was, perhaps a bit too much. Now, there is a noticeable tingling that begins at the chin and sometimes “crawls” up into the cheek, sometimes accompanied by a mild burning sensation.

     (Not a shooting pain; more like a tingling irritation.)

     I’m a bit irritated at myself, obviously, for having touched it too much. If I leave it alone, it tends to dissipate. So I am committed to not touching it anymore.

     Does this indicate something that needs fixing? What are my options from here on out?

     Thanks so much,
     Steven

     Steven :: 2 years, 5 months after

185. Case in point: I haven’t been touching it, it’s getting better / I’m forgetting about it, then shaving the chin today something feels a little weird and then there’s the slight burning in one cheek.

     Steven :: 2 years, 5 months after

186. Dr. Palmer.

     Thank you for your response to my post.
     I will be back in LA in January, and will make an appointment with your staff to meet for a consult. I know at a minimum, with my research thus far, I want to have Rhinoplasty and the chin implant. I am strongly leaning towards cheek implants at the same time also.

     I assume all 3 procedures can be done at once.

     Looking forward to meeting with you.

     FB

     FB :: 2 years, 5 months after

187. Hi Dr.Palmer,

     I am scheduled to come see you in about 3 wks. I am just concerned and hope that you read this and respond. I had a cheek implant removed 10 days ago and am still having some pain. It is like a kind of throbbing pain-not excruciating but does still hurt…I thought I would be fine by now. I don’t have major swelling or redness-the dr says I don’t have an infection..Could it be a small infection though they are overlooking? I’m scared this will last forever Maybe I’m just taking a little longer to heal? It was a porex implant. I know you don’t like those. I was having some pain issues and problems moving my upper lip w/it So it seemed wise to get it out sooner than it being more difficult later…Was 3 months after insertion..and was extremely small-was custom fit-and was a little bigger than the a fingernail. It was to fill in a flat area that doesn’t match the other cheek. This surgeon (world renowned) still didn’t think this was a big issue. But, it really bothered me. Now, of course it’s flat again. I talked to one of your assistants on the phone-she was so nice. And, she made me feel really good that you could help me. Obviously I’m not thinking of an implant right now-maybe you would say I could never have one again. But, am thinking of Radiesse instead. She said they can often look just like an implant. And the area I need is not real big where I need it. Do you think maybe the pain is just me taking awhile to heal? I can’t live in this pain forever And, I hate how flat it is, I’ve been so distraught over it. And, even second guessing myself about removing it. Hope I did the right thing-I thought long term it may be better, b/c I know they are so hard to remove later..I am sorry to go on and on…Hope you can help me,,,,

     Aimée :: 2 years, 5 months after

188. hi dr palmer, i had a chin implant placed through the mouth about 5 montes ago…im so unhappy with it. My smile changed a lot,i have skin irregualrities and i can feel one bump on of the sides. is it normal? I have been thinking about removing it, what ere the risks?will I look like i did before? Im so scared something could go wrong pease help me… thank you

     laura :: 2 years, 6 months after

189. Hello Dr.Palmer,

     I am a 25 year old female who was born with an awkward shaped forehead and head shape due to craniosynostosis.
     I am getting implants next week to make my forehead fuller and possibly for the back of the head as well.I have been informed that solid silicone sheets will be used as the implant material.
     I would like to know if there are any health risks associated with this and also if there is any chance of implant breakdown/rupture.
     My other question is whther there is any chance or permanent discolouratuion or pigmentation around the implant site.

     Looking forward to hearing from you soon,

     Thank you,
     Aliya

     Aliya :: 2 years, 6 months after

190. Aliya,

     I’m not doing your surgery, as you know, so I’m not entirely sure what the plastic and cosmetic surgeons will use. I can tell you that solid silicone implants are safe and will not dissolve or erode. I have used them in cheeks and chin and even Rhinoplasty for augmentation for almost 20 years.

     Dr Francis R Palmer

     drfpalmer :: 2 years, 6 months after

191. Laura,

     None of that sounds normal for a chin implant and I do many chin augmentations but never go through the mouth as it can cause some of the problems you’re describing. I’d have to see your chin to make further comment but you may consider having it removed…let everything heal for 3-4 months and then replace it through an incision under the chin. You can send photos for evaluation to drfpalmer1@aol.com

     Dr Francis Palmer

     drfpalmer :: 2 years, 6 months after

192. Aimee,

     As you know, I don’t use, recommend or like Porex facial implants. I don’t like the fact that they can’t ever be removed. Because I can’t remove them, I no longer am taking patients seeking my help in taking their porex cheek or chin implants out. I am sending them to the company rep for a referral.

     Dr Francis Palmer

     drfpalmer :: 2 years, 6 months after

193. Hello doctor, I am reomoving a 6 month smalll silicone chin implant in a month. My surgeon is doing through he mouth, as the first surgery. My question is do you usually have good results after removing an implant? (sagging, irregularities, lumps…)and how can you maje the tissues reatach tothe bone? is there bone erosion at this time? thank you very much, have a nice day

     laura :: 2 years, 6 months after

194. Hello Dr.Palmer,

     I had written in earlier and had implant surgery using silicone sheets for my forehead.I had my surgery on the 8th of December and the problem I’m facing now is that there’s a bulge about the size of a coin right in the center of my forehead.I’m not quite sure if thats swelling, becuase it seems more like the implant getting pushed up.
     As long as its kept comppressed it stays down, but the moment the pressure is released, the bulge is back.
     Right now I have tried using ice packs, but it doesnt seem to be doing much good.
     What can I do about this, and is it likely to be a permanent thing?
     Any assistance in this regard would be higly appreciated.

     Many thanks,
     Aliya

     Aliya :: 2 years, 6 months after

195. Hi Dr. Palmer,
     I am 2 weeks out of surgery. I don’t like the angular look the cheek implants have caused. my goal was to give a slight lift in my midface and correct the flatness. The implants sit high and far back on the bone (right under the eye). PS says we can go to smallest size and move down and forward. What affect would that give? I am contemplating taking them out all together. I didn’t want a different face structure just more of a youthful one that i had.

     2nd. My orbital rim implant is small according to PS but right now (still some swelling) everything sits far out. I also feel like i have puppy dog eyes..slight pulling down of my lower eyelids from the lower blephs. Doc said the eyes always go down and he’s concerned that it won’t be enough in a couple of months (hard for me to believe) as for the rounded eyes and slight pulling he said that will go away when everything relaxes and for me to massage it. Does that help ?

     tash :: 2 years, 6 months after

196. Aliya,

     Since I wasn’t there for the implant surgery and placement, I’m afraid I have no way of knowing what’s causing the lump. You might want to see the plastic and cosmetic surgeon that did your surgery for answers and guidance.

     Dr Francis R Palmer, III

     drfpalmer :: 2 years, 6 months after

197. Tash,

     Using facial implants to beautifully shape the face is truly an art. What size and or shaped implants were used on your cheeks? If these were narrow and thick…this is the expected aesthetic result. If, on the other hand, they were more comet-shaped and thin…the face becomes softer and more youthful without creating changes to the character of the face. That’s why I use that shape when I perform Cheek Augmentation with Implants.

     I am not a fan of, nor do I use tear trough implants…I’ve just never been pleased with the resulting facial aesthetic change and believe the implants are often too large and visible.

     In your particular case, you may want to have an in depth conversation with the plastic and cosmetic surgeon that did your impants and take a look at the size, shape and tickness of the implants in the sizer samples provided. If these look too high, thick, narrow etc. you may question if that’s the look you’re shooting for.

     My humble opinion….do not ask a plastic and cosmetic surgeon to use a cheek implant large enough to lift facial tisues as these are usually too big and tend to change and/or over power the face.

     You can read more about my idea of facial aesthetics and Cheek Implants here: http://www.drfpalmer.com/CheekImplants.html

     Dr Farncis R Palmer, III

     drfpalmer :: 2 years, 6 months after

198. Dr. Palmer,

     I am 29. I had a chin implant two years ago. I have not had any complications from the surgery thus far. My only concern about my chin implant is potential bone erosion. Should I have periodic examinations to check for bone erosion?

     Thank you for your time,
     Mandy

     Mandy :: 2 years, 7 months after

199. Dr. Palmer,
     Is there a rememdy if I don’t like the look of the buccal fat removal? I thought it would produce a different look which was hard to see through imaging. I’m not sure if it’s too sunken ( only had a small amount removed) or if it has more to do with me having lost alot of weight after the surgery. Probably both. What if I am not pleased with the way it turns out?

     tash :: 2 years, 7 months after

200. Tash,

     Yes, but that’s the reason I don’t do Buccal fat pad removals…it has a tendency to create hollow looking cheeks in my opinion. I’d have to see your cheeks or pictures of them to determine if Cheek Implants or soft tissue fillers like Perlane or Radiesse would be the best solution.

     You can e-mail jpeg photos to drfpalmer1@aol.com for review or call the office at 310-652-9583 to schedule an in person consultation.

     Dr Francis R Palmer, III

     drfpalmer :: 2 years, 7 months after

201. Mandy,

     I tell all my chin implant patients to have an X Ray by their dentist within the first 2-4 years after the chin implant to be sure there isn’t significant bone erosion.

     Dr Francis R Palmer, III

     drfpalmer :: 2 years, 7 months after

202. Dr. Palmer,

     Thank you for your response to my earlier question. I have a dental x-ray every year. So far, there has been no indication of bone loss. Will the dental x-ray determine bone erosion to the chin or will it only indicate bone erosion nearer to the roots of the teeth? I’ve heard about DentaScan. Is that essentially the same thing as a dental x-ray? Or, is it something I should be having in addition to the dental x-rays?

     Again, thank you for your time,
     Mandy

     Mandy :: 2 years, 7 months after

203. Mandy,

     Significant bone erosion is quite rare in my experience with chin augmentation and would not be subtle. If you’ve had a n X-Ray in the past 5 years, you may not require anything else. I don’t have my chin implant patients do anything else unless they notice a distinct change in the shape of their chin that may indicate bone erosion.

     Dr Francis R Palmer, III

     drfpalmer :: 2 years, 7 months after

204. dr. Palmer ,
     I am 32 year old male with round face , about year ago had chin implant terino style 1 large I asked my doc to also remove my buccal fat but instead he sugested malar implants what type would be appropiate I was thinking about terino malar shell medium 5 mm projection please advice , just want to make sure that the implant make ma face more angular/chiseld not more round
     Thank you for your time
     ‘alex

     Alex :: 2 years, 8 months after

205. Alex,

     As a plastic and cosmetic surgeon in Beverly Hills I perform many chin and cheek augmentations with Radiesse or implants. I haven’t seen your face, so it’s difficult to make a judgement about how to best create that angular ruggedly handsome look so desired in male faces. Having said that, you may want to re-consider a 5mm implant as that can take over the shape of the face and make it obvious that Cheek Implants are in place.

     I don’t want to step on the toes of another plastic and cosmetic surgeon if you’ve already chosen one…and you should be discussing these issues with the plastic and cosmetic surgeon who will be performing the cheek implant surgery.

     Dr. Francis R Palmer, III
     Creator “What’s Your Number”

     drfpalmer :: 2 years, 8 months after

206. Hi

     I had silicone cheek implants surgery last April in 2008, they were silicone cheek implants. I asked for small and he gave me medium,They are not equal, left side is much higher and sitting more to the side of the face. The right side the cheek implant moves plus it is much lower from the other. The implant make me look older and more masucline, I would like to have them removed and probably would have get a cheek lift instead. I would like your input on this matter.

     Karen

     Karen :: 2 years, 8 months after

207. Karen,

     I really need to see your face and what it looks like with the cheek implants in order to further comment. If you would like, you can e-mail photos to my staff at drfpalmer1@aol.com and even set up a telephone consult by calling the office at 310-652-9583.

     I do many cheek and chin implants and they really do make the face look more youthful and attractive but the right aesthetic size and shape of the implant is critical. The problem with a cheek lift is that the procedure tends to shift all the tissues of the face upward and outward and this may give the face an awkward, widened appearance. For creating cheek shape….cheek implants are the gold standard followed by soft tissue fillers like Radiesse and Perlane.

     If the cheek implants are silicone (silastic) they are quite easilly removed and replaced at the same time as long as the plastic and cosmetic surgeon didn’t screw or suture them in place.

     Dr Francis R Palmer, III
     Beverly Hills Plastic & Cosmetic Surgery
     Creator “What’s Your Number“

     drfpalmer :: 2 years, 8 months after

208. Our daughter had a large extended silicone chin implant removed via the mouth 8 weeks ago. Should all of the swelling be gone by this time and the chin we see now be the end result?
     Thanks so much for your reply.
     William

     William :: 2 years, 8 months after

209. William,

     Hard to say since I wasn’t the Plastic & Cosmetic Surgeon who removed the chin implant. I can say that I don’t place or remove Chin Implants from inside the mouth for several reasons.

     1. The mouth is not clean and the Chin Implant procedure can be done sterilly through a small incision under the chin.

     2. The intra-oral approach can cause the chin muscle to sag at a later time as it’s insertion point is in the dissection path when
     the implant is placed/removed through the mouth.

     3. The incision may be longer than that which is used under the chin.

     Any of these reasons along with prolonged surgery time and less experience could lead to prolonged swelling at 8 weeks. If you are concerned, you should contact and discuss this with the plastic & cosmetic surgeon that did the surgery.

     Dr Francis R Palmer, III
     Beverly Hills Plastic & Cosmetic Surgery
     Creator “What’s Your Number” System

     drfpalmer :: 2 years, 8 months after

210. Dear Dr Palmer,

     I had chin and cheek implants inserted over a year ago, so I suppose what I see now is what I got. I’m pleased with the way my face looks when I’m not smiling, but my smile is horrible! The other day, someone said it looks like I’m grimacing!

     The cheek implants seem to have widened my smile. I have narrow dental arches, but that didn’t matter before I had implants. Now, though, the corners of my smile are farther away from my teeth, and it almost looks like I’m missing teeth. Is this normal? Is there anything that can be done?

     The chin implant bothers me even more. Before, when I smiled, the muscles in my face used to draw my chin outwards, and my profile actually looked nice when I smiled (though my chin was quite recessive when I wasn’t smiling). Now the muscles seem to stretch the flesh over the implant and downwards, not outwards. It looks weird to me. It also changes the way my lower lip stretches. I wonder if the implant is just placed too high? The problem is that I have a long face, and I worry that an implant that is lower (but not *under* the chin or anything) might make my face look longer?

     I look forward to your advice. I wish my smile didn’t look so…sad.

     Thanks,
     Kristen

     Kristen :: 2 years, 8 months after

211. Kristen,

     Not sure why your face seems that much different after your Cheek Implants and Chin Implant. One year after these plastic and cosmetic surgery procedures, your facial implants are giving you the final aesthetic result. Since, I didn’t do your plastic surgery, I’d need to see you and or before and after pictures of your face which you can e-mail.

     Cheek Implants come in many shapes and sizes…many of which I do not use because I don’t believe they can provide the proper aesthetic shape to the cheeks….same for the chin and chin implants. A point that I make in my new book that describes the factors of beauty for the face and body as well as the inside beauty we eminate.

     Then there’s the issue of placement of the cheek and chin implants. As you mentioned if the chin implant is in a higher position….this may effect your smile. It’s also possible that the nerves that move the face were effected during your surgery.

     Dr Francis R Palmer, III
     Beverly Hills Plastic and Cosmetic Surgery
     Creator “What’s Your Number” System

     drfpalmer :: 2 years, 8 months after

212. Dr.Palmer:
     Is there less pain and swelling with a silicone chin implant placed under the chin rather than through the mouth?
     Also we were wondering as the face changes with age will the chin implant remain natural-looking since it doesn’t change?
     Thanks so much for your reply.
     William

     William :: 2 years, 9 months after

213. William,

     Cheek and chin implants will age naturally with the face.
     You can learn more at www.drfpalmer.com/CheekImplants.html

     Dr Francis Palmer

     drfpalmer :: 2 years, 9 months after

214. Dr.Palmer:
     How soon can a chin implant placed through the chin be inserted after the first implant was initially placed through the mouth 8 months ago and removed 3 months ago,also through the mouth?
     Will there be less pain and swelling involved since the pocket has already been formed? Will scar tissue be an issue? We’re thinking of having a smaller silicone implant placed since the first one, which was a 6mm projection was too large. Thanks so much for your reply! William
     We appreciate so much your reply!

     William :: 2 years, 9 months after

215. William,

     Very good question. What’s required in this particular case is the re-attachment of the chin muscle to the chin bone at a point just below the mid lower lip. This attachment of muscle is transected when the chin implant is placed through the mouth but remains intact when I place the chin implant from under the chin and under the chin muscle.

     If this attachment has not reformed, it’s possible that the new chin implant though smaller (6mm is quite thick) may be displaced upward toward the lower lip into the sulcus by the lower gums….which is not a good thing.

     So, the answer is , I’m not sure. I’d have to feel the chin and get an idea of whether the tissue is ready for another surgery (soft and pliable) and whether the muscles were re-attached. It typically occurs somewhere between 3-6 months…so I guess 6 months would be playing it safe.

     Having said that, the plastic and cosmetic surgeon must not dissect to far upward or that attachment will be transected again.

     If you want to send photos to my staff for my review send them to drfpalmer1@aol.com and you can call the ofice at 310-652-9583 for more info or to schedule a phone or in person consultation.

     Dr Francis Palmer
     Beverly Hills Plastic and Cosmetic Surgeon
     What’s Your Number(R) Book
     The Palmer Code

     drfpalmer :: 2 years, 9 months after

216. Dr.Palmer:
     We have a question regarding asymmetry in the upper lip following a silicone chin implant placed through the mouth almost 9 months ago and removed through the mouth almost 4 months ago. The PS told us no nerves were cut, just stretched and her lip will resolve. We’re wondering how long it will take for it to return to its normal state. There seems to have been a little improvement but it’s not resolved as of this date.
     Thanks so much for your reply.
     William

     William :: 2 years, 10 months after

217. William,

     You’ll have to wait about 1 year to be sure the nerve is all the way back…only the plastic and cosmetic surgeon who did the chin augmentation and the removal knows for sure what was done at the time of surgery.

     Dr Francis Palmer
     Beverly Hills Plastic and Cosmetic Surgery
     What’s Your Number…the palmer code book
     Follow me on Twitter

     drfpalmer :: 2 years, 10 months after

218. Dear Dr Palmer,
     I have a nicely pronounced chin and high cheek bones but I have a very weak jaw line. I have had rhinoplasty before and I am happy with everything in terms of symmetry size and shape on my face except my jaw. I am healthy, have no bone disorders and am only 21. However I live in Sydney Australia and I cant seem to find any doctors who perform this surgery or find any before and after pics on the internet.
     Could you please direct me to some advice?

     Sincerely desiree

     Desiree :: 2 years, 10 months after

219. Desiree,

     Jaw implants are typically used for men seeking a more angular, ruggedly handsome face and are fraught with complications of shifting and or eroding into the jaw bone. That’s why you are having trouble finding a plastic and cosmetic surgeon who does this type of surgery.

     Most importantly…are you certain this will make your face more attractive. According to my new book “What’s Your Number…the palmer code… the most important facial features are the cheeks, the eye area followed by the lips. The jaw line, especially in women is of far less aesthetic value and therefore priority. Please read the book and consider further evaluation and consultation with a qualified plastic and cosmetic surgeon before having jaw implants which may make your face to masculine in appearance.

     You can e-mail photos of your face to my staff for evaluation at drfpalmer1@aol.com and you can call the Beverly Hills office at 310-652-9583 for more information or to schedule an in person or telephone consultation. I have performed many, many facial implants over the past 20 years but jaw implants are rarely, if ever needed in women.

     Dr Francis R Palmer, III
     Beverly Hills Plastic and Cosmetic Surgery
     Follow me on Twitter
     What’s Your Number…the palmer code

     drfpalmer :: 2 years, 10 months after

220. Dr. Palmer:
     Our daughter is still having tingling sensations in her chin following a large silicone chin implant placed almost 10 months ago and removed almost 5 months ago–both through the mouth. Do we need to be concerned or is this a good thing? Could the tingling help resolve her upper lip which is still a little asymmetric?
     We appreciate your reply!
     William

     William :: 2 years, 11 months after

221. William,

     Tingling after a chin implant and then removal may be an ndication that the nerve is coming back which can continue for up to 2 years following the last surgery.

     Francis R Palmer MD
     Beverly Hills Plastic and Cosmetic Surgery
     What’s Your Number…the palmer code book

     drfpalmer :: 2 years, 11 months after

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