Mentoplasty with Submental Silicone Implant

Name the implant and potential complications • Xray of the Week

Figure 1. What is the name of this implant?

Discussion:

Mentoplasty refers to cosmetic chin augmentation that is often used to treat deficient chin projection caused by soft-tissue atrophy and retrusion of the chin (1). Chin retrusion may be further classified as underdevelopment of mandibular symphysis (microgenia) or mandibular retrusion (retrognatia) (2). Augmentation mentoplasty can be performed using various implant materials, autografts, and homografts, and silicone as in this case (1,2). Silicone rubber is preferred over other materials for its resistance to changes in body temperature, calcification, absorption, and degeneration as well as its pliability (2). The silicone implant is typically positioned inferior to the mental foramen in a subperiosteal pocket via an extraoral approach (1,2). Silicone implants are best seen on CT using bone windows, and there is typically variable attenuation with density that is higher than soft tissue but less than bone (1). On MRI, there is very low signal intensity on T1- and T2- weighted sequences (1). Complications include infection, migration, heterotopic bone formation, and foreign body giant cell reaction (1). Mandibular bone erosion is also a common complication and can be evaluated on CT with dental CT software (3).

References:

1. Schatz CJ, Ginat DT. Imaging of cosmetic facial implants and grafts. AJNR Am J Neuroradiol. 2013;34(9):1674-1681. doi:10.3174/ajnr.A3214

2. Vuyk HD. Augmentation mentoplasty with solid silicone. Clin Otolaryngol Allied Sci. 1996;21(2):106-118. doi:10.1111/j.1365-2273.1996.tb01312.x

3. Abrahams JJ, Caceres C. Mandibular erosion from silastic implants: evaluation with a dental CT software program. AJNR Am J Neuroradiol. 1998;19(3):519-522.

Amara Ahmed is a medical student at the Florida State University College of Medicine. She serves on the executive board of the American Medical Women’s Association and Humanities and Medicine. She is also an editor of HEAL: Humanism Evolving through Arts and Literature, a creative arts journal at the medical school. Prior to attending medical school, she graduated summa cum laude from the Honors Medical Scholars program at Florida State University where she completed her undergraduate studies in exercise physiology, biology, and chemistry. In her free time, she enjoys reading, writing, and spending time with family and friends.

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Kevin M. Rice, MD is the president of Global Radiology CME

Dr. Rice is a radiologist with Renaissance Imaging Medical Associates and is currently the Vice Chief of Staff at Valley Presbyterian Hospital in Los Angeles, California. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015, Dr. Rice and Natalie Rice founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field. In 2016, Dr. Rice was nominated and became a semifinalist for a "Minnie" Award for the Most Effective Radiology Educator.

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