Complications of Augmentation Mentoplasty: A Review of 11,095 Cases

Abstract

Augmentation mentoplasty is an increasingly common surgical procedure that reshapes the contour of the mental area. Presently, there is a paucity of information comparing the efficacy and potential complications of the various techniques and implant materials now utilized in correcting chin deficiencies. A survey was thus devised and sent to Fellows of the American Academy of Facial Plastic and Reconstructive Surgery. Ninety-two surgeons responded describing their results on 11,095 mentoplasty procedures. The overall complication rate was 7.6% with both intraoral and extraoral approaches having similar morbidity. Silicone prostheses had the lowest complication rate, while a higher incidence was associated with acrylic and Proplast® products. The ideal implant has yet to be found and the search should continue for more suitable materials.

Delayed Mental Nerve Neuralgia following Chin Augmentation

“…Complications of chin augmentation include infection, malposition of the implant (leading to patient dissatisfaction), and extrusion of the implant intraorally [1, 4]. A case series of 324 chin implants by Godin et al found an infection rate of 0.62%, while another case series of 125 consecutive patients by Aynehchi et al reported no infections [1, 5].…”

“…A preference for the transoral approach is evident in the literature as it avoids an external scar, which had been reported to cause scar alopecia in males [1]. The complication rates for both approaches are comparable, although some authors state a lower infection and malposition rate with the external approach [4, 9]. …”

Bone resorption after alloplastic augmentation of the mandible

“…The areas of resorption were in the region of 0.5–2 mm with follow‐up periods of 1–5 years. Furthermore, other surgeons felt that oversized implants were subjected to more mentalis stress leading to higher rates of resorption 3,15 …”

“…Scaccia et al . conducted a survey that covered 11 095 operations performed by 92 surgeons and showed that silicone rubber, which was the commonest material used, had the least complications when compared with acrylic and Proplast 3 . They quoted very low incidences of bone resorption although stating that most respondents admitted to rarely checking postoperatively for radiographic changes.…”

“…These patients often undergo augmentation mentoplasty to achieve a more aesthetic facial profile, which sometimes reduces the need for excessive reduction rhinoplasty 2 . Many materials have been tried for augmenting the chin in the past, but solid silastic has gained wide popularity in the last three decades and is, at the present time, the commonest implant in use 3 . Some authors have raised concerns about bone resorption beneath these implants, and an ongoing debate regarding the exact causation of resorption and their long‐term effects is yet to be settled.…”