Can Jaw Angle Implants Be Placed From the Outside?

Q: Dr. Eppley, I am a big fan of your work. I am from UK and for the kind of treatment I need my options here are quite limited. Very few surgeons are experienced in implants here in Europe. 

I am contemplating doing something to get my jaws wider and more defined. I do not have any overbite as confirmed from dentists, and my chin is also not poor. The only thing I lack is width in jaw. My cheekbones which seem comparatively wider and this makes the face looks too lean. I want to get the implants only at the angle as I feel they would be sufficient for me. And they seem a perfect solution. 

But I have some major concerns. I have come across many stories where people had to remove implants within a few years of having them. It was either because of infection or because of muscle disruption. (There may be some other causes but I know only these two) 

Therefore I want to ask you if you suggest to place implants from outside, rather than through an intraoral excision. (I am okay with marks, but I don’t want infection and subsequent removal of implants). Are there still chances of infection despite placing them for outside? Do you personally place them for outside for some patients? 

Also, in case of muscle disruption I want to know if it will occur even if I go for the smallest implant size, cause I most probably will, as the difference I need in my case is very subtle. Also in case muscle disruption still occurs, what are the options I have. And what are the chances of muscle disruption in small standard implants.

A: You are correct in that the transcutaneous approach for jaw angle implant placement would provide the best mitigation of the risks of infection or masseter muscle dehiscence. Small standard jaw angle implants are ideally suited for this placement approach.

Dr. Barry Eppley

Indianapolis, Indiana