Can A Custom Jawline Implant Be Done After A Sagittal Split Osteotomy?

Q: Dr. Eppley, I wanted to get a bit of information on your custom wrap around jaw implants to reshape my jaw line. I had recently had a Bilateral Sagittal Split Osteotomy and Sliding Genioplasty to correct a Class-II Malocclusion. I am currently unhappy with the shape and position of my lower jaw. As it stands I have a jaw that has downward growth; it has a high gonial angle, lacks bi-gonial width, short ramus length, and my chin is a bit recessed. My Maxillofacial surgeon recommended that I find a surgeon that has extensive experience working on reshaping male patient’s jaws. I had spoken to a few plastic surgeons but what caught my attention about your practice was an article you wrote titled “Plastic Surgery Case Study – Custom Jawline Implant Design for the High Gonial/Mandibular Plane Angle Patient”. In this article you went into detail about your procedure to bring a male patient who had a high gonial angle of 150 degrees down to 130 and the importance of understanding the relationship between lowering the gonial angle and the masseter muscle in surgery. 

I wanted to know if you have any experience working on patient’s who have had orthognathic surgery and if a custom wrap around jaw implant could help me get a more ideal male jaw shape.

A: Thank you for your inquiry. Approximately 20% of all custom jaw angle and custom jawline implant patients have had prior orthognathic surgery for the very reason you are experiencing. Orthognathic surgery serves a very valuable role in facial bone surgery but it is primarily affects the sagittal dimension of the face and is very limited dimensionally in what it can change thereafter. This is why it is not rare to see patients who have had single or double jaw surgery seek to use the jaw surgery as a foundation on which to create enhanced 3D features of their facial bones.

I would refer you to to look at some of the many jaw implant designs I have done in such patients.

Dr. Barry Eppley

Indianapolis, Indiana