Is A Custom Jawline Implant The Best Way To Fix My Facial Asymmetry?
Q: Dr. Eppley, As a child I had an orthodontist to a lot of extensive grinding of my teeth. Later, a car accident damaged my right TMJ joint. Over time, my face has shifted and to the right side. Four years ago I found the best orthodontist in the city and we have worked hard to undo the damage. Now, my bite is repaired and the “melting” right condyle has been stabilized. I am left with the last piece to fix: Correcting my facial tissue asymmetry! I already have a silicone chin implant. I have a large forehead that could balance well with an augmented jaw appearance.
Is there a high risk of the implants failing and has it happened in any of your cases? Is there a risk in my individual case for destabilizing my right TMJ due to the trauma from the pressure and inflammation from the surgery of this implant addition?
1)This shows the apparent asymmetry with tissue pulled and favoring the damaged right side. Note this is including recent botox to the masseter muscle with no change in appearance.
2) Please note that the R condyle is practically a toothpick in comparison to the L condyle in the TMJ region.
A:Thank you for your inquiry, sending your picture and detailing your history. In answer to your questions about a custom jawline implant:
1) Failure in any type of facial implant is defined as infection in which the implant needs to be removed. That is about a 5% risk in any standard jaw angle or custom jawline implant.
2) A jawline implant is laid on top of the bone and does not affect its function (opening/closing and chewing) other than during the recovery period from the trauma of surgery.
3) In looking at the panorex (which is a limited 2D assessment) the jawbone has no obvious asymmetry other than the diminutive right condyle.
Dr. Barry Eppley