Heterotopic Bone Formation around a Solid Silicone Chin Implant

Abstract

Objective: Solid silicone implants have been used successfully with few complications in facial cosmetic surgery since the mid 1960s. The objective of this paper is to report an unusual sequela associated with a solid silicone implant placed for chin augmentation. Methods: Case Report Case Presentation: A 28-year-old Caucasian female presented with complaints of changes in her chin appearance for the past 2 years. She had a mandibular solid silicone implant placed 11 years prior and was happy with the results for 9 years when she began to notice enlargement of the right inferior border which progressed over 2 years prompting a consult at my office. Clinical examination revealed a mild enlargement of the right anterior mandibular border when compared with the left. She had good chin projection and no noticeable mobility of the implant. Radiographic studies revealed a heterotopic bone along the right anterior border of the mandible. Under intravenous sedation and local anesthesia, the inferior mandible and implant were exposed via the previous extra-oral approach. The bone was exposed and removed from the chin implant, which was stable, and without infection. The wound was closed and the patient was discharged and did well at her postoperative appointment. Discussion: Solid silicone facial implants have been used with great success for a few decades by different specialties. A variety of complications have been reported, such as displacement, early and late infections, patient dissatisfaction with the result, bony resorption, and prolonged edema. This is the first reported case of heterotopic bone formation around a solid silicone implant to this author's knowledge. Conclusion: Heterotopic bone formations around a solid silicone implant likely result from an intact periosteum in conjunction with the nature of the silicone capsules.