Right Jaw Angle Sensitivity Six Weeks after Custom Jawline Implant Placement

Q: Dr. Eppley, I had a custom jawline implant placed six weeks ago. I can open my mouth fully and the swelling was pretty much gone around the 3 week mark. (As in, it was difficult to notice any further reduction in swelling.) There’s no numbness in the lip or the skin around the jaw.The implant looks pretty great, too. I would have benefited from a larger implant, but I am happy with the results in that it is still a significant cosmetic improvement.

Only one question: The tissue right at the angle of the mandible on the right side is sensitive to pressure. That is, if I press on it or the outer side I feel a dull ache. Sort of like a pressure point. I notice this when sleeping on my right side since the pressure on the jaw from the pillow can make it uncomfortable. It can vary in sensitivity depending on how often I try to sleep on that side (i.e. longer periods of pressure = more discomfort when reapplying pressure). I am wondering if this is might be, like abnormal sensory nerve regrowth or a ligament with a small tear. This issue has been present since I was able to start sleeping on my side after the surgery.

A: Every implant that involves the jaw angle has to elevate the masseter muscle off of the bone. This is particularly relevant in a custom jawline implant. Thus everyone sustains a large muscle ‘tear’ so to speak. There are no nerves or ligaments in the jaw angle area. Like many muscle injuries it can take up to three months to have full healing. Why one side would feel good and the other one is still sore is not rare and actually occurs most of the time. Bilateral surgeries never heal exactly at the same rate. I have no cause for concern at this still early point after surgery although it probably doesn’t feel that early to you.

Dr. Barry Eppley

Indianapolis, Indiana