Q: Dr. Eppley, After giving careful thought to the imaging and other considerations, I would like to further seek your expertise. I’m seriously considering scheduling a procedure soon, but need to make sure I ask your advice on some things, first.
Accordingly, at your earliest convenience, would you, please, advise on the following:
1) With the custom wraparound jawline implant, I have concerns about the likelihood of desired change from the front view. I have been advised that when one lowers the jaw angle, the masseter muscles (that predominantly contribute to the appearance of the jaw from the front view) sometimes fail to stretch with the implant, accordingly. Moreover, it is argued, the masseter muscle often still sits where it originally inserted, and the jawline implant extends below the muscle; yet, the implant isn’t really visible, so one attains this kind of rounded look at the angle of the jaw from the front view.
Would you please advise on the likelihood of either of these outcomes, with regard to my surgery, specifically?
2) Considering that the imaging projections present a “worst case scenario,” as you say, what elements of the surgery could turn out “better” than the imaging? Does the imaging show what I would look like with the liposuction or without?
A:In answer to your custom jawline implant questions:
1) There is always a risk of masseteric muscle dehiscence in any surgery that involves the jaw angles whether it be standard jaw angle implants or a custom jawline implant. An important element in the surgery is to lift the masseteric muscle sling off of the bone so that it stays over the implant after it is placed. But this sling attachment is thin and tenuous and the risk of a tear and muscle retraction always exist. The risk is higher in jaw angle implants that lengthen the jaw angles as opposed to those that just widen them.There is no absolute predicting who will or will not get it. Most of the time it does not occur but the risk is always present.
2) The purpose of the imaging is to show the least amount of change which should serve as the stimulus for surgery. (not the best case scenario) No one can say whether it will or what parts may turn out better.
Dr. Barry Eppley