Chin Augmentation Complications: Pain and Persistent Discomfort

Chin augmentation side effects?

Initially, I had a chin augmentation with artificial bone, but after six months, the tightness and foreign body sensation did not improve, leading to significant discomfort in my chin.
The doctor suggested that I could receive scar injections for improvement, but after the injections, I experienced redness and inflammation.
Although the swelling subsided after taking medication, my chin has remained persistently red since then.
Before the removal of the implant, I visited Chang Gung Memorial Hospital three times for my chin issue, seeing different doctors each time, but I did not receive a definitive answer.
Ultimately, I had to return to my original physician, who recommended removal of the implant.
However, after the removal, the tightness increased, the foreign body sensation intensified, and my chin became wrinkled and uneven.
The surgeon only advised me to massage the area to help soften the scar, but this did not resolve my issues.
When I inquired about possible examinations, the doctor stated that there shouldn't be any, as there is no longer an implant, only connective tissue remaining.
They were unsure why I still experienced pain and mentioned that there are no tests available to determine the cause of the pain.
On December 2, 2022, I underwent X-ray and ultrasound examinations in the rehabilitation department, which revealed swelling in the fascial layer.
I informed the original clinic, and their response was that scar management could only rely on heat application, massage, injections, and time for gradual softening.
However, over time, my condition has not improved and has worsened, sometimes becoming tight enough to cause pain, leaving my issue unresolved.
I would like to ask if the discomfort is solely due to scar hypertrophy, or if there is damage to the soft tissue in my chin.
Is it possible to perform an MRI on the chin? What would the cost be? Thank you!

Jing, 30~39 year old female. Ask Date: 2023/01/23

Dr. Zhou Hongzhang reply Plastic Surgery

I would like to ask if the discomfort is really just caused by simple scar hypertrophy, or if the soft tissue in the chin has been injured? Can an MRI be performed on the chin? What is the cost?
1.
Augmenting the chin should be less likely to injure important organs.

2.
Soft tissue injuries can cause redness, swelling, heat, and pain, which may persist for several weeks; some individuals may experience discomfort for several months.

3.
An MRI may not be necessary for this condition.

Reply Date: 2023/01/23

More Info

Chin augmentation, particularly with the use of implants, can lead to various complications, including persistent pain and discomfort. Your experience of ongoing tightness, foreign body sensation, and redness after the procedure is not uncommon, but it can be distressing and frustrating when the symptoms do not improve over time.
From your description, it appears that you have undergone multiple evaluations and treatments, including the use of scar injections, which unfortunately resulted in inflammation and further complications. The fact that you have experienced persistent discomfort even after the removal of the implant suggests that there may be underlying issues beyond just scar tissue formation.

Understanding the Complications
1. Scar Tissue Formation: After any surgical procedure, the body naturally forms scar tissue as part of the healing process. In some cases, this scar tissue can become thickened or fibrous, leading to a condition known as hypertrophic scarring or keloids. This can cause discomfort, tightness, and a sensation of pressure in the area.

2. Nerve Damage or Irritation: Surgical procedures can sometimes lead to nerve damage or irritation, which may result in chronic pain or discomfort. If the nerves in the chin area were affected during the augmentation or subsequent removal, this could explain the persistent pain you are experiencing.

3. Infection or Inflammation: The redness and swelling you experienced after the injection could indicate an inflammatory response, which may not have fully resolved. Chronic inflammation can lead to ongoing discomfort and may require further treatment.

4. Fascial or Muscular Issues: The ultrasound findings indicating swelling in the fascial layer suggest that there may be issues with the connective tissue surrounding the muscles. This can lead to tightness and discomfort, as the fascia can become restricted or inflamed.

Diagnostic Considerations
Regarding your question about whether an MRI could be performed on the chin area, yes, MRI is a useful imaging modality for evaluating soft tissue structures, including muscles, fascia, and nerves. It can provide detailed images that may help identify any underlying issues that are not visible on X-rays or ultrasounds. The cost of an MRI can vary widely depending on the facility and location, but it typically ranges from $400 to $3,500 without insurance. It is advisable to check with your healthcare provider and insurance company for specific costs and coverage.

Recommendations
1. Consult a Specialist: Given the complexity of your symptoms, it may be beneficial to seek a consultation with a specialist in facial plastic surgery or a pain management specialist. They may have more experience with complications arising from chin augmentation and could offer additional treatment options.

2. Physical Therapy: Engaging in physical therapy may help alleviate some of the tightness and discomfort. A physical therapist can provide targeted exercises and manual therapy techniques to help improve mobility and reduce pain.

3. Pain Management: If the pain persists, discussing pain management options with your healthcare provider may be worthwhile. This could include medications, nerve blocks, or other interventions aimed at reducing discomfort.

4. Follow-Up Imaging: If you have not already done so, consider discussing the possibility of an MRI with your doctor to further investigate the underlying causes of your symptoms.

In conclusion, while scar tissue formation is a likely contributor to your discomfort, other factors such as nerve involvement, inflammation, or fascial issues may also play a role. A comprehensive evaluation by a specialist, along with appropriate imaging, can help clarify the situation and guide further treatment. Your ongoing symptoms deserve attention, and it is important to advocate for your health and well-being.

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