Jaw Angle Implant Revision

Q: Dr. Eppley, I am interested in jaw angle implant revision surgery. I had Medpor jaw angle implants put in to correct asymmetry and enhance my small jaw several years after corrective jaw surgery. After jaw surgery my plate came off on the right side and needed to be replaced and I lost some bone. The surgeon used the same size implants on both sides and was suppose to build up the back right side of the jaw with hydroxyapatite paste. This did not happen. I still have the asymmetry on the right side in the back. I overall like the implant on the left side. Can you create a custom implant to correct the deficiency on the right side without removing the original implant? Also, I really dislike my chin the orthognathic surgeon gave me as it curves up and I would like it brought down a little. The surgeon who did my Medpor implants said he could correct my chin. I decided not to pursue him since he missed correcting my asymmetry in the first place.

A: It is a valid jaw angle implant revision concept that one could place one implant over the other in the jaw angle area. The key issue is whether a 3D CT scan will ‘see’ the Medpor material clearly enough to allow an accurate custom fit to be made. The only way to answer that question is to get a 3D CT scan. Sometimes Medpor material is not seen well or looks very fuzzy with irregular outlines.

For your sliding genioplasty it sounds like you need the sliding genioplasty to be vertically opened as it is over rotated.

Dr. Barry Eppley

Indianapolis, Indiana