LAM FACIAL PLASTICS

Dr Lam,
I had a silicone chin implant inserted via submental incision in Sept 08. I have decided to remove the implant due to it being crooked -I'd rather just look like my original self. Although I don't imagine it to be a very difficult process, I do have some concerns. Your input would be so very much appreciated!!!

1. I have read on the internet that the capsule formed around the implant needs to be removed, in addition to the implant. If the capsule is not removed, the tissues that surrounded the implant will not be able to re-adhere to each other. Is that true?

2. I'm a healthy 32 yo female and the chin implant was a silicone, "button" type. The ps called it a medium size, but I think it probably added about 4-5 mm of projection; and the width is a bit shorter than the length of my lips. Do you think I'll have any problems with sagging tissue/flesh when the implant is removed?

3. I may have an implant reinserted (hopefully by you!) in the future. Do you think it's a good idea to remove and then wait a year or so for reinsertion. Or, is it better to just reinsert another implant at the same time as removal? Or, is there no adv/disadv between either scenario?

4. Are there any other adverse considerations I should think about before removal?

Dr Lam, thank you so very much for your input!! I wish I had lived in Texas, I would just drive over to see you. And I appreciate all you expert advice on this forum!!!

1. I have read on the internet that the capsule formed around the implant needs to be removed, in addition to the implant. If the capsule is not removed, the tissues that surrounded the implant will not be able to re-adhere to each other. Is that true?
NO, LEAVING THE CAPSULE IS FINE. IF ANYTHING, I LIKE THE CAPSULE BECAUSE IT WILL PROBABLY MAINTAIN SOME CHIN PROJECTION DESPITE THE IMPLANT BEING GONE. FOR A WOMAN, IT COULD BE JUST ENOUGH.
2. I'm a healthy 32 yo female and the chin implant was a silicone, "button" type. The ps called it a medium size, but I think it probably added about 4-5 mm of projection; and the width is a bit shorter than the length of my lips. Do you think I'll have any problems with sagging tissue/flesh when the implant is removed?
IF YOU HAVEN'T EXPERIENCED SAGGING SO FAR (THAT IS THE MENTALIS MUSCLE WAS CLOSED WELL) AND YOU ARE YOUNG (WHICH YOU ARE), THE SKIN SHOULD SHRINK BACK. JUST MAKE SURE WHOEVER REMOVES THE IMPLANT, METICULOUSLY CLOSES THE MENTALIS MUSCLE AND SKIN IN MULTIPLE LAYERS. YOUR SKIN SHOULD SHRINK BACK. IF IT DOES NOT, WHAT I DO TO FIX THAT PROBLEM (WHICH REALLY SHOULD NOT HAPPEN TO YOU) IS A TINY WEDGE RESECTION OF SKIN AT THE SUBMENTAL INCISION IN WHICH I TACK THE MENTALIS MUSCLE BACK TO PERIOSTEUM TO LIMIT SAGGING. IT IS BASICALLY THE TECHNIQUE THAT I PERFORM FOR A SO-CALLED WITCHE'S CHIN DEFORMITY THAT CAN NATURALLY OCCUR IN SOME INDIVIDUALS WHO JUST HAVE A WEAK MENTALIS MUSCLE AS THEY AGE.
3. I may have an implant reinserted (hopefully by you!) in the future. Do you think it's a good idea to remove and then wait a year or so for reinsertion. Or, is it better to just reinsert another implant at the same time as removal? Or, is there no adv/disadv between either scenario?
FOR A WOMAN WHO MAY NOT NEED A LOT OF PROJECTION, REMOVING AND SEEING MAY BE THE BEST SCENARIO. OBVIOUSLY YOUR CONSULTING PHYSICIAN WILL HAVE TO TALK WITH YOU ABOUT YOUR SITUATION. I DO NOT WANT TO VIOLATE THAT SACROSANCT RELATIONSHIP.
4. Are there any other adverse considerations I should think about before removal?
I REALLY THINK THAT IS IT. SILICONE IMPLANTS ARE EASILY REMOVED IN THE OFFICE. GENERALLY SPEAKING NO BIG DEAL.