Your Questions
Your Questions
Q: Dr. Eppley, I am currently about to get double jaw surgery and already have a weak midface and undereye area (bad case of dark circles). Ideally I would like to get midface implant surgery soon after the jaw surgery. I want a lot of mass added to my cheekbones area especially the undereye area. I know the implants will extend to my zygomatic archs will this help change the shape of my face? I feel like I have a very rectangular face and would like some width added to the midface area. Some questions I have:
– How soon after the jaw surgery would I be able to get the implants placed?
– How will this process work, do you suggest a virtual meeting and then travel to the clinic? Basically what is the process like from beginning to end?
– Lastly how big can the implants me, not coverage but how forward or thick can the implants be? What constraints are there to how thick the implants can be?
A: In answer to your midface implant augmentation questions:
1) One would wait six months after a Lefort I osteotomy to have a midface implant procedure. But you would get the process starter within a few months after the orthognathic surgery since it takes a minimum of 3 months to go through the implant design and manufacturing process to get the implant ready for surgery.
2) A 3D CT scan is needed and that can be obtained locally. We place the order for you to have it done. You only come here for the actual surgery.
3) Within what your aesthetic requirements would likely be there are any implant thickness or tissue constraint limiting factors.
4) While I do not know at this time know some of the important features of the midface implant design that would work best for you (implant footprint, single or split design, intraoral vs lower eyelid placement approach) my staff will provide a general quote for the procedure.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, i always wanted a more heart shaped, small chin and jaw, soft, youthful face instead of square or long. id love your opinion on how i could achieve that look and what seems like the biggest problems. id like to get filler/botox soon but im interested in surgery if it still feels needed. i was thinking jaw botox might be a good start. maybe temple and cheek filler? im 20, slim build
A: The single most important change you need to make your face more heart shaped is to vertically lengthen and narrow your chin. The lower third of your face is disproportionate to the upper two-thirds because your jaw is flat (near zero mandibular plane angle) with a vertically short chin and a wide jaw angle region. You can do filler and Botox in other areas but they will make little difference in changing the shape of your face as they don’t address the real problem. They may provide some minor benefit but the foundational change is that of the lower jaw….vertically lengthen the chin (vertical lengthening bony genioplasty…aka mini V line surgery) and jaw angle width reduction. (masseter muscle reduction by Botox or bony jaw angle and masseter muscle reduction by surgery)
Dr. Barry Eppley
World Renowned Plastic Surgeon
Q: Dr. Eppley, Hi.. how are you? I’m interested in fixing my shoulders with implants, to make them wider. Also in that surgery I would also like to change my breast implants.
Im attaching some pictures so you can see my problem
If possible we can schedule an online meeting so we can discuss everything.
Thank you in advance and hope you can help me 🙂
A: Thank you for sending your pictures. Admittedly I have never done shoulder lengthening in a female and presumed that I never would….until I saw your pictures and then the desire for it became very clear. Even if you could get even 15mms per side the shoulders would look wider and less rounded. Usually 15mm widening per side in men has proven to be the limit due to the strong shoulder girdle muscles but perhaps in women this is less of a limiting issue??
Dr. Barry Eppley
World Renowned Plastic Surgeon
Q: Dr. Eppley, five months ago, I underwent double jaw surgery together with V line and cheekbone reduction surgery in South Korea. The result of the line and cheekbone reduction surgery was not what I expected, and I have regretted it since. How long should I wait for before having a reconstructive custom jaw line implant surgery and cheekbone reduction reversal.
A: At five months postop you can proceed with any further facial bone surgery. The bones and soft tissues are well healed to do so.
Dr. Barry Eppley
World Renowned Plastic Surgeon
Q: Dr. Eppley, I came across your practice from Google and wanted to reach out and ask some questions or possibly set up a consultation. I have a very thin, narrow face and as I’ve aged (42 yrs old) it’s only gotten more emphasized. I had previously had an chin implant put in but I feel as though it almost made my face look longer. Recently I’ve been getting fillers in my jaw, in front of my ear region and in my lower face to build up some volume but it doesn’t seem to be helping and, for the cost, it feels like going the permanent route might make more sense. I don’t know if there is much than can be done for a narrow face but I’d love to get the doctor’s feedback on it.
A: In the thin narrow face the effective reshaping approach is to shorten it and widen it. A chin implant in a thin narrow face will often make it look longer which is why a sliding genioplasty that brings the chin forward and vertically shortens it is a better chin augmentation procedure in that facial shape type..
Where you have been placing injectable fillers is in the jaw angle region and placing widening jaw angle implants would be a more assured and effective approach. Another effective approach is cheek augmentation, particularly in the malar-submalar region for some midface widening/volume addition.
Dr. Barry Eppley
World Renowned Plastic Surgeon
Q: Dr. Eppley, I have a question in regards to the placement of mandibular angle implants (PEEK/silicone).
In your experience over the last years/decades of placing mandibular implants – normal sized to small implants so not radically large ones – how many of your patients have showed signs of (partial) masseter (PS) disruption/dehiscence? And how many in relation to how many you’ve performed in total?
If a patient had no signs of masseter muscle dehiscence is there a chance that the PS/masseter will be ripped or comprised after surgery after a big hit, yawn or other trauma?
Thank you very much if you find the time to answer.
A: Masseter muscle dehiscence is an immediate sequelae of jaw angle implant surgery that becomes evident when the swelling subsides. It is not something that occurs later even if trauma occurs.
The risk of masseteric muscle dehiscence is directly related to whether the jaw angle implants add vertical length which requires release of the muscle attachments along the inferior border and angle region where the ligament attaches. That risk is about 5 to 8%. In widening jaw angle implants that risks lower to less than 5%.
Dr. Barry Eppley
World Renowned Plastic Surgeon
Q: Dr. Eppley, I am looking for infraorbital rim implant and i have beem told you are the best surgeon, i got many questions if you could answer them please, is it permanent?, will it fix my scleral show?, will it make my eye more deep set and almond eyes looking?, thank you for the time given dr. Have a good day!
A: With your negative orbital vector (cornea of the eye sticks out further in profile than the infraorbital rim) you have a true skeletal deficiency which is why your lower eyelids are rounded with scleral show. You are correct in that infraorbital rim implants (ideally custom so they saddle the rim and help push up the lower eyelids) are one important part of the solution but not the only one. Spacer grafts are needed for the lower eyelid to ensure vertical lengthening lid support and lateral canthoplasties to get more of the almond eye look.
Dr. Barry Eppley
World Renowned Plastic Surgeon
Q: Dr. Eppley, I’ve been looking at your custom jawline implants and I have a question. How high along the ramus can a custom jawline reach. All your custom jawline implants only augment the area below the bottom row of teeth along the ramus. Is there an anatomical reason for this? Thanks!
A:Because it is aesthetically counterproductive to place any augmentation higher up on the ramus in most cases. All that does is push out the masseter muscle fullness which works against having a more defined jaw angle region.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I would like to come to see you for perioral mound liposuction (if applicable). However, I would only be able to go by myself. If I come alone, would I still be able to have surgery if I take an Uber?
2) I had a chin implant and buccal fat removal procedure done about 2 years ago, but my cheeks still seem chubby at the bottom and I’m not sure if they are my perioral mounds or my jowls. Can you please take a look at my photos and advise if this can be fixed? Please keep the photos anonymous. Thank you so much in advance!
A:Technically you do have perioral mounds and a bit of jowling. But on a practical basis perioral mound and lateral facial liposuction is what you likely to do. While a jowl tuckup procedure would produce the best result you are unlikely to be motivated to have that procedure at your age.
Such facial liposuction procedures are performed on an outpatient basis. As a general rule we don’t permit a patient to climb into an Uber ride right after having a general anesthetic.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello Dr Eppley! About 1.5 years ago, I had a custom wrap around silicone jaw implant to fix what i felt were subtle assymmetries. I’m a 35 year old woman, and thought for some reason this would give me the same face shape, only sharper.
This has not only masculinized my narrow face into a square one, but makes my jaw look boxy rather than tight. After intense depression and being told by my doctor that my constant pain and discomfort would go away ( it hasn’t), he’s now agreed to remove it. I wish he had when I first wanted it out, which was right away.
My question is this: I have not been able to find many pictures of jaw implant removal– only chin implant removal. I am afraid of developing jowls after this or loose, sagging skin and tissues. My surgeon removing it says not to worry, and that no muscle repair will be necessary, which makes me even more scared to go through with this.
Will I look anything like my old self even if not identical? Do you remove these implants? Have you done so on women? Can you help me?
A:Removing a wrap around jawline implant is certainly less traumatic than putting it in. The question you are asking is will your face go back to the way it was before the implant placement. That is a multifactorial question based on size of the implant etc. But it is safe to assume that it will largely go back but I would not expect it to be 100%. Changes may occur along the posterior jawline, such as jowling and a little bit of loose tissue over the jaw angle areas, as you have mentioned. But given your dissatisfaction with the outcome (undoubtably a result of the design…women jawline implant designs are much different than men and the most common design error is to not appreciate those aesthetic facial gender differences), whatever the soft tissue changes may be by removing it should be a worthwhile tradeoff.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am not happy with the aesthetics of my eye, even if I can consider that I have a good shape of the eyes in fact I already naturally have almond eyes I think that the eye is too high because I have a low and round lower eyelid, I would like have a more masculine eye therefore less high and straighter I would like to know which would be the most suitable operation among those you perform to make the lower eyelid straight and raised and what the indicative cost would be, I also made a morph to let you understand what I mean.
A: You have mentioned that your eyes are too high because your lower eyelids are too low. In reality your eye position is good/normal but the lower eyelid is too low. Anatomically you have this appearance because you have a negative orbital vector. (the cornea of the eye protrudes in profile further than the infraorbital rim) In essence you have an infraorbital rim deficiency and, given that the shape/position of the lower eyelid parallels that of its supportive underlying bony infraorbital rim, it is no surprise that your lower eyelids are more rounded.
Understanding the anatomic reason for why your lower eyelids look like they do tells how to best raise them and make them straighter. (aka vertical eyelid lengthening) This requires a combination of infraorbital rim implants and spacer grafts to the lower eyelids.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I had a question about Le Fort I Osteotomy. From what I saw online the procedure is able to raise the nasal spine of the maxilla. Would this then shorten the vertical height of the nose by raising the base of the nose? The issue that I have is that my nose is vertically long but the tip is not the issue so a rotation would not work. As such I was wondering if the osteotomy would raise the base of the nose to shorten it. It not is there other procedures that could do so. My goal would be to have the vertical height be shortened by 3-4 mm. Thank you for your time.
A:You can’t shorten a nose by altering his skeletal base. That will not change the large overlying nasal skin envelope.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have a question about eye area; what procedures would be necessary to replicate those eyes? My eyes are not as deep set and instead of this angular shape are more almond shaped. Canthal tilt also sits lower. So I guess orbital implants with horizontal and vertical projection would be necessary. But how much vertical augmentation of supraorbital rim can be achieved and will brows come down?
I attach front and profile of my eyes and the ones I would like to achieve. Thank you very much.
A:I don’t think you can replicate that eye shape exactly. But certainly periorbital augmentation is the key with brow bone augmentation being the most important. The eyebrows will come down with brow bone implants particularly with a design that lowers the bone edge…just not as much as the example you have provided.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am writing to you because I have an asymmetry of the jaw, the right is more developed than the left, I am 28 years old and to have more symmetry I thought of one of your customized implants on the less developed jaw, but first I would like to have an idea of the result aesthetic of my face by temporarily adding volume to the jaw in a reversible way for this reason they advised me to do a test with a lipoffilling or the Radiesse, in his opinion which is better of the 2 products to fill the less grown jaw and understand the aesthetic result that would I have a fuller face waiting to do the custom implant?
A: While the use of non-permanent injectable fillers is a good first step in treating jaw asymmetry I certainly would not use fat as it can be hard if not impossioble to remove later if the long term plan is an implant correction.. Radiesse is a long lasting filler and would be fine if an implant correction is 18 to 24 months into the future. Otherwise hyaluronic-based injectable fillers would be a better choice as they last less long and are easily reversed. As an aside fillers or fat placed in the subcutaneous tissues do not have the same aesthetic effect as bone-based implants.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have what I think is brachycephaly with a very flat back of the head but also the sides of the back of the head are pointy and flat. My question is how much bigger and rounder can these areas become with a custom skull implant? Also does the silicone feel soft ? Like if someone touches those areas can they feel it ? Or if you lay down does it feel soft or just like bone?
it’s like my head doesn’t have a back, its appears cut in half. I think my case is very very very severe. I can’t go outside without a hat. I think if you can fix this it will be truly life changing for me ! I hope and pray and I’m waiting for your answer. thank you
A:Thank you for sending all of your pictures. You do have classic brachycephaly which accounts for the shape of the back of your head. That can be improved by a custom solid silicone skull implant which will feel just like bone. The amount of augmentation is controlled by the stretch of the scalp and I would estimate that to be in the amount shown. (see attached image)
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am wondering if I am a good candidate for rib removal. I am also looking to downsize my breast implants and was wondering how that would relate time wise to get rib removal.
A:Thank you for sending your pictures. Lean patients get the best waistline results from rib removal surgery of which you fall into that category. That would need to be combined with abdominal liposuction in your case. Breast implant size change can be done before, at the same time as rib removal surgery or after. If done before or after I would allow 2 months on either side of the waistline narrowing surgery.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I’m sending this email as an inquiry into Aesthetic Skull Reshaping Procedures.
I’ll start with a bit of an overview of my situation and what I hope to achieve:I’m a bald male. I have a depression/groove in the top right side of my skull. As a result, the right-side profile of the top of my head is concave while the left profile has a gradual convex shape. I’ve provided photos to clarify my description
It is my hope that a small custom implant (about 5cc volume) can be shaped and inserted to fill in the depression, to give the right side of my head a more convex shape similar to that of the left side (though I’m not expecting perfect symmetry).
I do also have a couple of more specific questions:
- I’m concerned the filling material would be noticeable and unnatural looking with my shaved head (e.g. the edges can be seen). Are you confident this would not be the case and how do you prevent this?
- How do you ensure the implant is placed in the correct location on the skull?
- I live overseas. Would it be practical to undergo this process with online consultations and a single two-week trip?
Thank you for your time. I hope to hear back with your thoughts soon.
A: You have correctly surmised that a small custom skull implant is the correct solution to what is known as a coronal suture line dip. In answer to your questions:
1) Feather edging of the implant design is what prevents what is known as ‘implant reveal’ or visible edging.
2) It takes a lot of experience to know how to properly position skull implants through small scalp incisions. But the location of the incision and knowing how the implant is supposed to fit are the keys. (this is why a custom design is needed)
3) The entire process, except for the actual surgery, is done in a virtual manner.
FYI The vast majority of aesthetic skull reshaping patients are just like you, the male with a shaved head.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello, I am a young female 117 lbs and 5’5. I’ve always had a very round fat face despite being very skinny everywhere else. I think one of the main reasons for this is my recessed chin. I’ve been looking into genioplasty and chin implants, but i’ve read that through genioplasty it can also help my jawline. My dream results would be a pronounced jawline and normal chin that matched my weight (I feel like Ariana Grande is a very good example). I don’t know if such drastic changes would be possible with just genioplasty or if I would need filler or liposuction. I currently live in Texas, but so have heard such amazing things about you, so I am willing to make the commute.
A:I don’t think there is any question that a sliding genioplasty (10mm plus forward movement is the preferred chin augmentation procedure and would make a world of difference for you. That combined with some midfacial defatting (buccal lipectomy and perioral liposuction) with make a major facial transformation.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I understand that a cheek implant is placed primarily on the bone, but I was wondering how far off the bone can a cheek implant hang? Especially in the submalar region?
Thank you
A: Cheek implants are commonly positioned off the bone onto the masseteric muscle fascia to obtain lower cheek fullness. It can go as far down along the masseteric fascia as the intraoral vestibular tissues will allow.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I would like to discuss the options for a chin revision. I had a chin augmentation in January 2021 and the removal of the implant in May of 2021. Since then my facial structure has changed significantly, which the lower part of my face becoming wide along with issues regarding my smile. Therefore I’m looking to see if liposuction/mini facelift are options to correct this issue? Look forward to hearing from you! Thanks so much!
A:Thank you for sending your pictures. What has happened is rather classic from your chin implant surgery. Placement of the chin implant necessitated release of the overlying soft tissues. Once the implant was removed the soft tissues are never going to go back exactly to what they were before. Thus you went from a v-shaped chin to now a wider/flatter chin shape. There is not any way to directly manipulate the soft tissues of the chin to regain that appearance as it is a direct result of degloving of the soft tissues. While there may be some aesthetic benefits in your case to the options you mentioned (submental liposuction and a jowl-tuckup procedure (aka lower limited facelift) their effects would be to improve everything around the chin but I would not assume that will bring back completely the previous chin shape. It will definitely help, however, improve the wider lower facial shape.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, But I saw you comment on a question forum about my exact issue so what I think I have is chin ptosis! For years I have been getting filler in my chin to correct it and was considering a sliding genioplasty or implant but what I realized I really want is for the fleshy pad on top of my chin to be shortened, it is too long and extends even further when I smile and talk. I am in the process of trying to make my face “smaller” by reducing the fleshiness in the lower half of my face. My chin has really been standing out to me, I believe the filler is migrating too even though I’m adamant with the injectors to not place it anywhere in the lower part of my chin, I only get the filler to project it forward and fill in the hollow crease right below my lip which causes a shadow that really bothers me. I got x rays done at a dentist so I’m attaching that since it’s probably helpful! Please excuse the purple Halloween costume but that photo my chin looks crazy so I thought it would be a good example. Any way, depending on the price of this procedure I may make an appointment to travel to IN sooner than later and maybe combine it with one of the implants? Please let me know what you think.
A:You have a natural large soft tissue chin pad to bone ratio which can clearly be seen on your lateral cephalometric x-ray. This becomes more apparent when you smile as it pulls down creating hyperdynamic chin ptosis. You have correctly surmised that a soft tissue chin pad reduction is the correct procedure to improve it.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, thank you for your time. I know you are busy. I am an avid reader of your online content, blog, and responses on forums. I have a question I hope you can answer, as I feel you are the best expert on this.
I have long history of many intra-oral chin implant surgeries, which unfortunately resulted in me having lower lip incompetence. I then underwent a mentalis resuspension using a large PEEK implant with holes to accept sutures for the mentalis, as well as holes made in the alveolar bone to re-attach the mentalis. This resulted in shortening of the vestibular sulcus and restoration of my original lip height and labial competence.
However, my mentolabial groove is no longer as deep/pronounced as it used to be. I have read that this groove is supposedly an anatomically fixed site that cannot be made more shallow unless through fillers, fat grafting, or even implants, but I insist that I used to have a deep groove, and it is now shallow/less noticeable.
Oddly enough, I liked having the deep groove, as I felt it made my chin look more pronounced as a man. Everything I read online is about patients and surgeons attempting to minimize this groove and prevent it from becoming too deep, but I *want* the deeper groove I used to have.
My questions are:
1) Is it possible that intra-oral procedures and mentalis resuspension can inadvertently make the mentolabial groove more shallow.
2) Is it possible to make this groove *deeper*, perhaps through liposuction, or further vestibuloplasty.
I appreciate your time. I know you are busy. I am thankful for your time.
A: Given what you have been through to get to this point, I would accept the tradeoff of a less shallow labiomental sulcus for the lower lip competence improvement., Trying to make it deep again risks a return of some of the very improvements you have now obtained.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am a 27 year old trans woman and I am very interested in having rib removal surgery for waistline narrowing. I have a few questions:
1. How long must patients stay in town before flying home?
2. Is it possible for me to have this procedure on my own without a support person? Does the clinic offer any nurses for aftercare? If not, can you recommend any locally?
Thank you so much for your help.
A: Thank you for your inquiry in regards to rib removal surgery. In answer to your logistical questions:
1) Most rib removal patients return home 3 to 5 days after the surgery.
2) It is very common that patients come by themselves for this type of body contouring surgery. We have a nursing service that gets you back to the hotel the morning after surgery as well as can provide some intermittent support for a few days after the surgery.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have a broken zygomatic arch that was not repaired in time which has resulted in loss of facial symmetry. What can I do to correct it now?
A:To determine the best corrective approach for a displaced zygomatic arch fracture a 3D Ct scan is needed so there is a clear understanding of the actual bone position and how best to repair it. In some situations, unless the infractured bone segment is impinging on the masseter muscle (causing pain), a camouflage approach (leave the bone where it is) may be used for facial contour restoration.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have a question regarding the combination of standard chin and jaw angle implants.
How do they connect? I´m aware that they are 3 separate implants, which are not connected by screws or anything like that. But will there be visible gaps between them if you wrap the skin around them very tihghtly?
How can it look like 1 uninterrupted jawline instead of 3 “hills”? Or is another technique like wrap around custom jawline implants better regarding that concern?
A: The wrap around jawline implant is the only jaw augmentation method that makes for a smooth connection between the chin and jaw angles. That is one of its many features/advantages.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Can I get an advancement sliding genioplasty if my chin is not recessed? Like its perfectly lined straight with my lips but i want to advance it for an even more forward grown look. Thank you.
A: A sliding genioplasty can be done just as easily/effectively in a chin with normal projection as in the recessed chin.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hi, could you tell me all of the risks involved with your post-genioplasty procedure of intra-oral release and fat graft? Also how long does recovery generally take? And can this procedure help to raise the lower lip a bit to cover the lower incisors more / reduce lip incompetence?
Thank you!
A:The only real risk of post-genioplasy release and fat grafting is how well/effective it would be.
One of the goals of the procedure is to raise the lower lip a bit….the hardest post-genioplasty sequelae to improve long-term.
Recovery is much more rapid than the original sliding genioplasty,. being a week to 10 days at most.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello, I have had a Le Fort Osteotomy for sleep apnea in 2020, and am unhappy with my jaw appearance after (too narrow, undefined). I tried a jaw implant in 2021 but it became infected and had to be removed. I am wondering if a custom jaw implant would be an option for me?
Thank you
A: Almost always a custom wrap around jawline implant is the most effective approach for jaw augmentation after orthognathic surgery. I would need to see some pictures and do some computer imaging to see what type of changes is desired/possible.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello, I’m interested in clavicle shortening. However, I’m wondering if this would make my collarbone a lot less visible. I already have not really visible collarbones and I’m worried they will fully disappear.
A:Good question and actually the reverse of your concern, becoming more visible, is more likely to occur due to the application of the superior fixation plate.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I recently had custom peek jaw implants in Europe, they look great and have healed well. The only issue is that the right hand side implant was ever so slightly malpositioned, such that at the point of contact along the mandible (about half way between gonion and chin) the implant edge is raised maybe 1-2mm off the bone (such that I can feel (but not see) a little lump along the bone)
I know jaw implants are meant to last for life (correct me if this is not a correct asumption), but is that longevity at risk if the implant is slightly malpositioned? I’m worried that if I press hard on the notch at the end, if I press hard enough the implant will snap into the 1-2mm gap toward the bone and break or the screws will be pulled out or something (eg if i got punched in the face). Can I still expect the implant to last for life?
A:Even custom jaw implants can be malpositioned, most commonly at the jaw angle region. Such malpositions do not affect the longevity of the material. PEEK is a very strong plastic material that you can not bend or break.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
