How Can My Jaw Angle Implants Be Revised To Give More Vertical Lengthening?

Q: Dr. Eppley, I had silicone jaw implants placed last year but I feel that they have added too much lateral width and not enough vertical lengthening. Would you recommend replacing them with the RZ Jaw Angle Medpor implants or would it be better to just shave down and reposition my current implants? Also, are Medpor implants much more expensive than their silicon counterparts?

A: The biggest problem with current silicone jaw angle implants, regardless of manufacturer, is that they provide little to no vertical lengthening and only width or lateral augmentation. Most of these implants have been designed based upon a normal jaw angle shape from skeletal models, which patients desiring augmentation do not have. A ‘weak’ jaw angle is as much vertically short as it is narrow. Increasing jaw angle definition, given that it lies at the intersection of the posterior and inferior mandibular borders, is a three-dimensional consideration.

Your aesthetic result from silicone jaw angle implants is not a rare one. It would be extremely difficult to try and reposition your existing silicone implants because they are not designed to engage the lower border of the jaw and would thus be unstable. The smooth surface of silicone would have the implants sliding back up and out of position  before the wound would even be closed.  In addition, the design of current silicone jaw angle implants makes it virtually impossible to stabilize their position on the bone with screws placed from an intraoral approach. The Medpor RZ implant to which you refer would be one of the few choices that would offer you an improved jaw angle result. The cost of any Medpor implant is appreciably more expensive than silicone.

Dr. Barry Eppley

Indianapolis, Indiana