Can Custom Jawline Implants Be Placed In A Previous Osteotomy Site?
Q: Dr. Eppley, I want custom jawline implants placed. I want to know how difficult the operation is to place custom Medpor jaw angle implants? I have had two surgeries, a bilateral sagittal split ramus osteotomy with genioplasty and an inverted ramus osteotomy to correct the sagittal split osteotomy. Even though I have custom Medpor jaw angle implants already fabricated, I am not comfortable with my current surgeon to place them…I want to know if you would be able to take over the case? What is the risk of infection? Thanks in advance.
A: Custom jawline implants have many advantages over standard shaped implants, particularly those made of Medpor material as they are more difficult to shape during surgery. Medpor jaw angle implants, and medpor implants in general, have a higher risk of infection because of their porous properties than that of smooth nonporous silicone. Thus these implants must be handled with great attention to detail. The implants must be impregnated with antibiotics, and that is important and easy to do, but the far more important issue is adequate soft tissue coverage over them. This requires careful dissection of the tissue flaps over the jaw angles and great attention to a water tight closure. Having had two prior procedures before, this makes this pocket development and closure more challenging due to scar but, in my experience, can still be done very successfully.
Dr. Barry Eppley