BIlateral Mandibular swelling

34 year old female was referred from her dentist for mandibular swelling. Patient was complaining of lower jaw pain and swelling of 2 days duration and has been febrile for the past week. Health questionnaire was also negative for any systemic disease and patient claimed no past surgical history. Examination of the face was consistent with  lower facial swelling not extending beyond the lower mandibular border and skin was flushed and warm to palpation.  Bilateral mandibular body and chin and all lower teeth were tender to palpation and all lower teeth have plus 2 mobility. No decay was observed on any of the lower teeth.   Panoramic x-ray was taken and no odontogenic source for the infection was identified. Periodontal exam was also negative. A Cone beam CT was taken and a silicone mandibular implant was identified spanning from right mandibular body to the left. The  implant had resorbed the cortical bone.   Upon further questioning about past surgical history patient said she was embarrassed and did not disclosed the implant placement since her husband might find out!!
IV antibiotic was given and the implant was removed under general anesthesia.