Could I Get Orthognathic Surgery After Having A Custom Jawline Implant?
Q: Dr. Eppley, I have discussed in the past regarding his thoughts on whether orthognathic surgery could also be done in my case. While my bite is not far enough apart at this point (partly because my lower teeth have developed an forward angle to compensate) , I am considering potentially have my lower teeth replaced with an implant supported prosthesis (all on 4 or 6) at the advice of a prosthodontist due to the condition of those teeth and he seemed to indicate that could make it possible to have my lower jaw advanced. I’d really like to get your opinion on whether you feel this is a possibility (as it’s a procedure we’ve again discussed previously by e-mail). I really feel like advancing my lower jaw would provide further aesthetic benefit (while the jawline/chin implant certainly has helped in this regard, I still feel like my short lower jaw is noticeable — at least to me) and perhaps addressing it could even improve my sleep apnea as well. If he feels it is a possibility, is this a procedure that you perform (I am almost certain I’ve read where you have done it in the past but not really mentioned on the site) and if so, is it something that can be done potentially outpatient? I believe you had indicated to me in the past that it could be if only one jaw is involved.
A: The key question in orthognathic (jaw) surgery is the patient’s bite. Jaws are moved so that the teeth interdigitate better, thus there has to be a ‘malocculsion’ induced beforehand by orthodontic manipulations. Whether that can be done given your current bite relationship and what those movements would be requires an orthodontic evaluation since they are the ones that would be making those movements so they are in the best position to judge what is possible.
I would also bear in mind that with an indwelling jawline implant doing a lower jaw advancement would require its removal…so I doubt given the effort that has been put into getting it there that is infection free and in good position would be worth undoing it. It is probably better to just ponder increasing the amount of chin augmentation (which is only what lower jaw advancement would accomplish anyway) by either only chin augmentation or moving the chin bone forward with the implant.
Dr. Barry Eppley