How Much Jaw Angle Width Do I Need?

Q: Dr. Eppley, I have two questions.

1) With custom Peek infraorbital-malar implants, what is the minimum increase in bizygomatic width in millimeters, and what increase levels do you generally prefer?

2) I have inwardly turned gonions and I want to neutralize them or make them slightly outwardly turned. With custom Peek jaw implants, approximately how much of an increase in bigonial width would be necessary? I don’t want my face to look too wide and blocky.

A:In answer to your questions:

1) The minimum increase in the width of an IOM implant at the zygomatic level depends on the patient’s aesthetic preference. In other words how strong of an effect do they want which is obviously going to vary for each patient. If you define the minimum width as the least amount of material that can be manufactured that would put it in the 1.5 to 2 mm range.

2) By normal anatomy the ramus of the mandible in many male patients turns inward and is not in perfect linear alignment with that of the body of the mandible in front of it. If the goal is to neutralize the inward angulation of the ramus this would be determined on a 3-D CT scan where it can be accurately determined (see attached picture).

Dr. Barry Eppley

Plastic Surgeon