Q: Dr. Eppley, I have some questions about custom wrap around jaw implants. Firstly, how secure are the wraparound implants regarding the likely of it becoming displaced or dislodged? What level of force or impact could it withstand without being dislodged? Secondly, when considering the probable chin length projection provided by the implant, is there a means to prevent my labiomental crease from becoming deeper/more exaggerated, as I am already unhappy with its current depth?
A: Wrap around jaw implants are very secure given their custom design and fit and the use of multiple point miniscrew fixation. I could not tell you how much force it would take dislodge a custom jaw implant as that has never been tested. I would imagine that it would be considerable and would have to be of the magnitude that would be enough to break the jaw.
When any portion of the chin is advanced forward, some deepening of the labiomental fold is likely. This is unavoidable in a straightforward horizontal chin increase since the labiomental fold is a fixed point caused by the superior attachment of the mentalis muscle. When the chin is also advanced vertically, any change in the depth of the labiomenal fold will be less. I would use the imaging to be a good test as to what happens to the labiomental fold since it has not been moved with the chin change. Lessening of any labiomenal fold depth increase can be told by simultaneous fat injections to it.
Dr. Barry Eppley