Posts Tagged ‘jaw implants’
Friday, January 27th, 2012
Q: Dr. Eppley, I would like to send some photos so you could tell me the most appropriate surgery to have. I would like a wider face, a less pointy chin, a chin lift and jaw implants. I wore braces to correct an underbite and I had a mandibular osteotomy and genioplasty – the result is a long face. What can I do to bettr improve my overall appearance. I am 39 years old and terribly unhappy with my profile and double chins etc.
A: You have many of the sequeale of orthognathic surgery of the lower jaw which occur from both the surgery and aging. While a sagittal split mandibular advancement osteotomy and genioplasty have undoubtably done wonders for your bite and improved your facial profile, there are some skeletal deficiences from that surgery that have either been created or unmasked with aging that have affected your lower face. Your face has become narrower with that surgery as the jaw angles are usually lost from the ramus osteotomy and the chin becomes more narrower as its u-shape comes further forward. There also appears top be some asymmetry of the lower jaw with the left angular area being more deificient than the right. There is also the effects of aging as the neck has become fuller and dropped down due to soft tissue sagging. Collectively, all of these give you a narrow and longer appearing face with a double chin and obtuse neck angle.
This could be improved by a single procedure combining a chin-prejowl implant, mandibular angle implants, neck liposuction and a limited or short scar facelift. I have done some computer imaging from the front and sides to illustrate what changes may be possible through this approach.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, jaw implants, mandibular angle implants, neck liposuction, short scar facelift
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Wednesday, December 28th, 2011
Q:Hi Dr. Eppley. I will be 17 years old next summer. I’m looking to get some implants as I get a little older. Is there any way of creating a custom jaw/chin implant? If so, would this cost extra? If so, how much? Much appreciated. Also, what is the minimum age requirement if one wanted to get some facial implants? I’d like as much information as possible please. Much appreciated.
A: The timing of chin and jaw implants is based on two factors; the degree of jaw deficiency, one’s bite or occlusion and the near completion of jaw growth. At this age you want to be sure that you do not have a correctable malocclusion by a combined orthodontic and orthognathic surgery approach. If not, then chin and/or jaw angle implants may be appropriate. I certainly would not perform that surgery before the age 18 when jaw growth is closer to being complete in a male. Custom chin and jaw implants can be done and I do them on a regular basis. But whether they are really needed and offer any advantage over stock preformed implants must be determined on a regular basis. It is hard to give any reasonably accurate pricing when I don’t know whether one needs just a chin implant or whether one needs a combined chin and jaw angle implants for total jawline enhancement. In either case, custom implants will double the price of the surgery due to the need for special design and fabrication. For this reason, one has to have a very compelling anatomic need to justify the expense of a custom facial implant process.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implants, dr barry eppley, indianapolis, jaw implants
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Thursday, August 18th, 2011
Q: Dr. Eppley, my jaw grew asymmetrically from birth. I had a surgery when I was 18 years old where they shaved off part of the chin, and added implants around much of my jaw. However, when it was done I thought my face looked too full. I had a second surgery to remove some of the implants. The result was better, but I am still not satisfied. I don’t need to look perfect, but I don’t enjoy having one side of my face be fuller than the other. Would it be possible to do surgery and simply shave off a little of the implant? I don’t want it out, because it needed to be in there, it is just too large.
A: Onlay augmentation of the jaw with implants is a common method to improve jaw asymmetry. This is a good treatment option when an osteotomy and occlusal adjustment is not needed or desired. There are numerous types of implants used in the jaw including silicone, Medpor (porous polyethylene) and Gore-Tex. (polytetrafluoroethylene) Each has their own advantages and disadvantages but they all share one similarity…they are relatively easy to carve and shape with a scalpel. Even though you did not say and may not even know what type of material that was implanted, it should be able to be pared down to a smaller size without the need to remove it first. Jaw implants are usually fairly easy to modify once in place.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, jaw implants
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Friday, October 22nd, 2010
Q: Dear Dr. Eppley, I am about to undergo a third surgery for my short mandible. My first surgery consisted of bone grafts to the jaw angles with a sliding genioplasty for my chin. I then had a second surgery in which silastic jaw angle implants were placed as the bone grafts had resorbed. For my upcoming third surgery, a medpor chin implant is going to be used which will extend back to the jaw angle. My doctor is concerned, however, about placing the medpor implants over the indwelling silastic implants (to improve the angle still) because of issues with bonding medpor to silastic. I assume it will take some method to secure the two implants together. He is concerned with slippage of the two implants placed on top of each other. Do you have any suggestions as to how to fix these two implants together? Your comments will be very appreciated. Thanks.
A: Commenting on another surgeon’s operative plan or method of surgery is not really appropriate from my perspective. I am certain that your surgeon would not really appreciate it and, if he needed help in the planning, he would have his own reference sources to ask. In addition, the details of exactly what has been previously done and the specifics of this next proposed surgery are lacking in your brief description of the issues. I wish you the best in this upcoming surgery and hope that your desired final aesthetic goals from your jaw reconstruction will be successfully met.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, implants for mandible reconstruction, indianapolis, jaw implants, plastic surgery
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