Is My Jaw Angle Implant In The Right Place and Is It Too Big?

Q: Dr. Eppley, I am just over 3 weeks out from having double jaw surgery (3 piece lefort 1 w/BSSO).  I also had cheek implants added because of deficient mid face growth. Lastly I had a mandibular jaw angle implant on one side only… reason was that  the other side has a little bump that jetted out and the implant was to make both sides symmetrical. However, swelling/ that side of my face where the angle implant was placed is way bigger than the other side. I got steroid shots but no improvement. My doctor said the swelling is preventing the jaw to set properly in the joint on that one side which makes it look worse. Two other things he noted: location for that implant requires much more than just reposition the jaw like the other side…he said it requires positioning it under the back muscle which requires work that induces note swelling. 

I noticed the structure itself compared to the other side was not symmetrical when putting my finger to both and using my ears to gauge. He said not to use that because the tissue on one said was thicker than the other so he accounted for that so you can go off bone because it will even out when settled in which could be 7-9 months.

Would like to get someone else to look at it to be sure it’s not the implant size that’s incorrect and too big. Pretty sure it was a Medpor implant…. 12 months from now could make it hard to replace.

However, if this is all normal and you’ve seen similar instances turn out well given time to heal, I wouldn’t mind that and happy to wait… just want a good outcome.

Thank you for your time!! 

A:I do not comment on any surgical result while under the active care of their primary surgeon. That is both inappropriate and a disservice to both the patient and the surgeon. What I can say as a general statement is that when the positioning of any facial implant is in question, whether it is 3 weeks, 3 months or 3 years, you don’t guess by external look or feel. You get a 3D CT scan which can show the exact position of where the implant is.

Dr. Barry Eppley

Indianapolis, Indiana