Can Jaw Angle Implants Be Put In From The Outside?

Q: Dr. Eppley, Hi, I currently have mandibular implants, off the shelf from Implantech.  I am unhappy with the off the shelf size and contours and have decided I need custom implants to reach the desired look. My question is can the implants be placed from and outside incision, rather than intra-orally? My current implants were placed from inside of my mouth and that was the WORSE part of the surgery. Not being able to open my mouth for 3 weeks = not eating for 3 weeks. Plus the pain on the inside was very bad. I believe by placing the custom implants from the outside incision would be much more generous when it comes to pain and downtime. Is this possible, opposed to intra-orally placing the implants? Any feedback would be greatly appreciated.

A: Jaw angle implants can certainly be placed from external skin incisions although in an aesthetic facial operation it is hard to imagine that the resultant neck scars might not be a concern. You should know that any replacement of your existing implants would likely be easier the second time around since the pocket under the muscle has already been partially created. Also, what is done on the side or below the jaw bone is the same whether one comes from inside the mouth or below in the neck (jaw opening restriction), the incisional approach is just a means to get there to do it.

Dr. Barry Eppley