Can Jaw Angle Implants Be Made To Replace What Was Removed From Jaw Angle Reduction Surgery?
Q: Dr. Eppley, I am interested in jaw angle implants but for an unusual reason compared to most people who have jaw angle implant surgery. I naturally had well defined and square jaw angle which are not considered aesthetically desirable in Asians. I had jaw angle reduction surgery which I came to now realize is the old style amputation of the jaw angle bone. This has resulted in the soft tissue which has fallen and moved forward and therefore the frontal view of my face is now heavier than before. A CT scan also showed that the angles are not even and or the same on both sides. In addition, the angle is a lot steeper than before. Overall, the face is considerably narrower than before as the bone has been cut off. However, the face does not look better as I have a jowl (premature aging) due to this soft tissue which has fallen. Now, I am thinking that I would like some of that angle back as my new jaw has no definition. My questions about this potential surgery are:
1. I’d like to have a bit of an angle back to give the face definition. However, I don’t want the face wider. (I have a short face, and fear jaw implants will make my face rounder.) What would you do to obtain this?
2. What is the risk of any complications such as infection?
3. What material is the custom jaw implant be made of? I heard some say it’s made of acrylic PMMA? Is this safe? What material is the safest?
4. How many years can I keep this jaw implant?
5. Is it possible that I send you a CT scan in order for you to make a custom jaw angle implant? How long will it take for you to make this custom implant?
In addition, I have kept the jaw bones which were cut off.
A: In answer to your ‘reconstructive’ jaw angle implants questions:
1) The jaw angles can be replaced by implants that restore the angular shape (in the dimensions of height and length) but that adds no width at all and stays in line with your current jaw width.
2) While infection is always a risk with any implant in the body, I have only ever seen one and that was with a porous implant material. Infection in jaw angle implants, like most facial implants, is very uncommon.
3) I prefer silicone material for all facial implants when possible. This is because it is easy to insert (and remove if necessary), has the lowest risk of infection of any implant material, and is the least expensive to manufacture particularly when it comes to custom made implants. (PMMA implants can also be custom made using a skull model made from your CT scan and hand fashioned)
4) These implants should be permanent, will never break down or need to be replaced. (provided the desired aesthetic objective is achieved)
5) I would need to see the CT scan to see if it is adequate for custom implant manufacture. It would need to be a 3D CT scan done in high resolution.
The other very unique possibility since you still have the cut off pieces of jaw angles is to use them to manufacture the implants by designing directly off of them. I have never done that before but then no one has ever still had the their removed bone specimens.
Dr. Barry Eppley