Can Jaw Angle Augmentation Be Done Using Bone Grafts?

Q:  Dr. Eppley, I was wondering if you performed jaw augmentation using bone grafts.What do you think about using bone grafts to increase the mandibular angle? Would you recommend it? And if you prefer other materials, why is that? I was browsing the web for some before and after photos of jaw augmentation using bone grafts, but to no avail.  If you perform this procedure, and have done so in the past, would it be possible to see some of your work? Thank you!

A: There is a good reason why you can not find jaw angle augmentation using bone grafts…it is not done. It would be a very poor procedure for cosmetic jawline augmentation for the following reasons. First, onlay bone grafts to the face undergo partial or complete resorption. For the purposes of volume augmentation, much of the grafts would likely be lost or they would lose shape. Secondly, the amount of bone graft material that could be obtained and its thickness is very limited. Even using skull, hip or rib bones, it would be difficult to get enough material to adequately do both sides. This is not to mention the pain, discomfort and scars that would result from their harvest. Thirdly, most jaw angle augmentations require vertical lengthening which would mean placing part of the bone graft out into space. This would completely resorb.

For these three major reasons, and a few minor ones that I didn’t mention, synthetic implants are far superior to bone grafts for jaw angle augmentation.

Dr. Barry Eppley

Indianapolis, Indiana