Can My Malpositioned PEEK Jawline Implant Be More Accurately Repositioned?

Q: Dr. Eppley, I’d like to schedule a virtual consultation to discuss options to revise or replace a PEEK wraparound mandibular implant that’s malpisitioned by 3-6mm vertically and 2mm laterally. In the attached pictures, the rough, yellow implant is the 3D render from CT scan of the implant that’s implanted in my head and the smooth, tan implant is the planned position of the implant.

A: Thank you for your inquiry and sending the jawline implant images to which I can say the following:

1) Who designed this implant? As such an implant design was bound to  have a misplacement problem. How they got it even this close to the designed alignment is a miracle in my opinion.

2) I can see that the implant was designed to replace the bone removed in either a prior V line surgery or sagittal split osteotomy. But you never make a pure vertical lengthening implant that only expands the inferior border as exact placement is almost impossible.

3) You have to have at least some lateral flange areas to optimize placement and implant fixation.

4) The only way to salvage this implant is using an external jaw angle incisional approach with plate fixation to the angle.

Dr. Barry Eppley

Plastic Surgeon