Facial Implants

London surgery Harley St Aesthetics offers face implants as one of the plastic surgery procedures on offer. The following information has been prepared to help you understand:

• what chin implants are
• what they are intended to do
• what they may or may not achieve
• what the risks are
• in general what you will likely experience after the surgery.
  

Please read this information carefully and comment if there is anything you do not understand. Please ask questions.

Face implants general information

Exciting new developments in chin augmentation include new implant shapes, textured surfaces, and more bio-compatible face implants. The face is now divided into zones and custom implants are prepared for the patient. This further introduces aesthetic enhancement into facial implant surgery over the conventional one-sizes-fits-all philosophy of implant placement.

The face implants are usually made of dimethalpolysiloxane, which is a silicone compound. Occasionally other materials may be used. Prior to the surgery, the type, size, and method of placement of the facial implants will be discussed carefully with you.

Face implants pre-operative preparations

You must be in good health to undergo any elective cosmetic surgery. A physical examination and routine lab work will need to be performed by your own primary physician. If you do not have a primary doctor, we can refer you to local doctors in our area. We do not provide these services. It will be required that all this pre-op paperwork is in our office 1-2 weeks prior to surgery.

• It is very important that our office is aware of any medical conditions and all medications you are taking.
• It is imperative that you not smoke 2 weeks prior to surgery, and 2 weeks after surgery. This would impede your healing greatly. Talk to us about options.
• It is a required that someone drive you home upon your discharge. Also arrange for transportation to and from our office for your post-operative appointments until your doctor gives you permission to drive.
• Do not take aspirin or aspirin-containing products for 2 weeks prior to surgery and for 2 weeks after surgery.
• An adequate diet with vitamin supplements, especially Vitamin C, is recommended. You should be in the best nutritional state possible prior to surgery.
• If you will be preparing your own meals at home after surgery, have on hand easy to prepare foods. A soft diet, such as mashed potatoes, yoghurt, apple-sauce, soups and jelly are helpful the first 24-48 hours after surgery.

Surgical procedure for face implants

The face implant procedure is frequently done in conjunction with a facelift or other facial surgery, but it may also be done as an isolated operation. It is usually done under general anaesthesia in our outpatient surgery centre, or under local anaesthesia with sedation if so desired. There is absolutely no pain involved during the procedure because of the anaesthetic. The procedure takes approximately one hour to perform.

Facial implants risks and complications

As with any surgical procedure, there is some risk. The administration of any medication of any sort can rarely have an unpredictable or, in extreme cases, fatal outcome. Every caution is taken to prevent possible drug sensitivity and if it should occur, to treat it properly and avoid any dire consequences.

Motor nerve injury is rare because the motor nerves usually are not vulnerable to injury from this kind of procedure. If such an injury occurs, temporary or permanent damage to facial muscles of expression may result. Weakness of the smiling muscles however is usually due to trauma to the muscles themselves, and in almost all cases can be expected to abate completely within a few weeks although some cases have taken between six months and a year to completely return to function.

Infection occurring immediately after surgery is quite uncommon because of the use of antibiotics and the careful surgical technique used in the procedure. However, late infection meaning infection occurring anywhere after three to six months, may occur due to a dental abscess or other infection which seeds the blood stream with bacteria, causing bacteria to lodge on the face implant and create a localized infection. In most cases, infection of this nature is readily responsive to antibiotics but on rare occasions, the infection is recalcitrant to antibiotic therapy, and the only treatment is to remove the implant and let it heal for a period of up to three months or more in order to completely eradicate the infection. At that time, the face implant may be reinserted.

It is wise to remember that foreign bodies of any sort can be the focus of an infection, and so when an infection occurs or when one goes to the dentist for a cleaning or other dental work, one is encouraged to take antibiotics immediately prior to that procedure. This is the same prophylaxis that is recommended for patients with certain kinds of heart disease, patients with breast implants, patients with joint replacement surgeries and patients with pace makers or other foreign bodies dwelling within their system. This simple precaution prevents infection quite reliably.

Malposition is quite unusual but may occur and be apparent immediately after the surgery. It is unlikely that face implants will move or "slip" to a different position once they have healed. It must be remembered that faces are rarely symmetrical and that sometimes this asymmetry is not perceived prior to surgery, only becoming noticed by the patient after surgery has been performed. Asymmetry, if significant, can only be corrected by undergoing another operation in which the implant is repositioned, or a different type of implant is inserted.

Hematoma, a small collection of blood within the face implant pocket, is quite unusual but may occur and requires the re-opening of the wound in order to take out the blood clot. It is not dangerous, but must be treated properly to avoid either malposition or an unusual amount of scar tissue post-operatively.

What to expect after face implant surgery

The swelling should begin to subside within three to five days along with the discomfort. It is not uncommon to experience some temporary numbness in the lip or weakness of the smile. This is just due to the body's inflammatory response to any surgical operation and usually within one to three weeks both of these functions are returned to normal. It is expected that you will be presentable in approximately one week.

Dressings - Immediately after surgery, a chin strap with foam padding is applied, and worn for 3-4 days.

Post-operative care

• Wearing the chin-strap with foam padding is required for the first 72 hrs, then you may shower, and discard the padding. Continue wearing chin-strap for an additional week, or as advised by Dr. Kremer.
• Wash face gently with a mild soap and water. AVOID scrubbing around the chin area.
• It is expected that you will remain somewhat quiet and sedentary for the first few days after surgery. This is to reduce the swelling and reduce the chances of bleeding in the area around the facial implant. After the first week, in the absence of other procedures that require a longer convalescence, normal activity may be resumed although it would be wise to avoid sports or exercise for up to three weeks after the surgery.
• It is important to keep your head elevated for the next 7-10 days. Sleep on your back with 2-3 pillows underneath your head and avoid rolling on your sides.
• After 10 days, make-up may be applied unless advised otherwise by the doctor. Please wait 2 months after surgery before having any dental work done.
• As with any facial surgery, avoid bending forward as this creates strain on all incisions that are healing.
• You should report to the office if you experience any excessive pain, any rise in body temperature over 100°F (38°C), or any excessive bleeding. DO NOT brush teeth vigorously for 1 week after surgery - use a child's toothbrush gently.
• AVOID excessive talking and smiling for 3 days after surgery.
• Complete the course of antibiotics prescribed to you by this office. 
• The general rule of thumb for resuming any physical activities is simple - take it easy! Patients who are too vigorous frequently develop complications. 
• At two weeks: take long walks on a flat surface but no other kind of workouts should be attempted. Any activity that would raise your blood pressure would compromise the healing incisions and newly developing blood supply.
• At four weeks: light exercise such as aerobics is ideal, but no weight training. Start light. For example, if you normally do 30 minutes on a treadmill, begin with 15 minutes, then increase as your body gets used to things. Use of vitamin C and E concentrate and scar-fade gel should begin as soon as the incisions are completely healed, usually 3-4 weeks.
• At six weeks: resume all previous activities with clearance from Dr Kremer. Avoid sun exposure to incision site for months following surgery, as this may result in a hyperpigmented scar.

Men

Many men suffer under the chin and want a more prominent, male-looking chin. A very strong jaw has traditionally been viewed as particularly male. It is always surprising to see what a positive change, in this case "masculinisation", takes place. Men who have previously suffered a poorly developed chin, develop a completely new sense of self-confidence.

Today, there are a number of different chin implants made of silicone or Goretex. This can be performed under local anaesthesia or sedation through a small incision under the chin or placed inside through an incision in the oral mucosa on the chin. A chin implant can often produce a harmony in the face - when the proportions of the face match, the patient clearly gains self-confidence. With chin implants, it is also possible to reduce a chin that you may find too prominent chin. In London, it is common to combine this surgery with rhinoplasty. This is called a plastic profile, and the facial profile can be significantly altered by the combination of these procedures.