Jaw Angle Augmentation

Q: Dr. Eppley, I am interested in jaw angle augmentation. I understand it is not a good idea to extend the jaw angle implant back closer to the ear.  I have few question for you. Hope that’s okay? 

You mentioned standard jaw angle augmentation implants may be suffice.  I assume custom made is other option? What is the difference/advantage between off the shelf implants vs custom made?

If custom made, what is the time frame to have them made as I’ll be entering US on 90 day waver visa? 

I’m told jaw angle augmentation surgery can be much more complicated then chin and cheek implants ( because main nerve of the face close that area) and not many surgeons do this procedure for that reason. Not sure what I’m asking you here but maybe you can fill me in on your knowledge and experience in doing  jaw angle augmentation implant surgery and if it is in f act the main nerve that is in danger? Thank you!

A: In answer to your questions:

1) Custom made jaw angle implants are better if one has significant asymmetry, unusual or altered jaw angle bony anatomy or the patient’s aesthetic needs exceed what standard made implants can do. Custom made facial implants are done from the patient’s 3D CT scan and take about 30 days to design, manufacture and be shipped for surgery.

2) Jaw angle implants are the hardest of all facial implants to perform, and have the greatest risk of complications (infection and implant asymmetry), but it has nothing to do with the facial nerve or any other nerve. It is because the access and visibility to place them from inside the mouth is limited, the precision of placement over the jaw angle bone is critical, most surgeon’s have no experience in understanding jaw angle aesthetics and proper implant selection, there is the risk of masseter muscle disinsertion with improper dissection technique, and the risk of intraoral incisional breakdown, implant exposure and infection is high without meticulous wound closure. In other words the comparative simplicity of a chin implant should never be confused with the challenges of its more posterior cousin the jaw angle implant.

Dr. Barry Eppley
Indianapolis, Indiana