Can Jaw Angle Implants Be Placed Through A Neck Incision?

Q: Dr. Eppley, I am interested in getting jaw angle implants placed from the outside as opposed from inside the mouth. What is the size and length of incision if we went through outside? Are the scars predominately visible or dark? If I choose to go with the external incisions, would they be near the facial nerves and would the nerves be subject to damage?  Can you direct me to before and after photos of your work with jaw angle implants please? And even better, any example photos that show what the external incision scar would look like.

A: If one was to place jaw angle implants through an external approach, the location of the incision would be in the classic Risdon location. This is the incisional approach through the neck to repair fractures of the mandibular angle which has been used for over fifty years. This classic mandibular angle incision is located two finger-breadths or about 3 cms. below the jaw angles in a horizontal neck skin crease. It’s length is also about 3 to 3.5 cms. It is placed in this location because that places it below the path of the marginal mandibular branch of the facial nerve which controls the depressor action of the lower lip. If well placed and executed the scar is very acceptable…although never as scarless as an intraoral approach.

Dr. Barry Eppley