Jaw Angle Implants

Q: Dr. Eppley, I am getting jaw angle implants that are of a standard vertical lengthening size that you have designed. The look that I am trying to achieve is a jaw that isn’t “high up”. One that is not quite lined up with my chin but low enough. So I’m just concerned that this will leave me with just a “slight” change and still leaving me with a high jaw line. From your experience and knowledge what is your expectation? I just payed for everything and set for our consultation, I apologize for the questions and concerns, but this is so important to me and Im spending my savings. So all I want to know is, what to expect. Can you not give me some assurances as to the results? 

A: The reason I am being nebulous with the answer to your question is two-fold. First it is an accurate statement that no one can predict what the final results will truly look like. Will it be better than what you have now…absolutely yes. Will it meet your expectations….unknown. This is no different that a woman getting 350cc breast implants and asking will it meet her expectations. It is certainly going to be better but whether they are big enough or have the right shape can be hard to answer with absolute certainly. Secondly, the very question you keep repeatedly posing is exactly the reason why your surgery, and any young male who is getting facial bone augmentation, makes me nervous. As I have said before, you are aiming and probably expecting a result that is only going to be achieved by custom made jaw angle implants. But because that it not a viable financial option for you, you are hoping that any non-custom approach will produce satisfactory and fairly assured results. The importance of that to you is further emphasized by your statement that you are spending your savings for the surgery. Patients who put themselves in this financial position, particularly young male patients, often end up with unsatisfactory outcomes.

I would like to emphasize that this is not the type of assurance I can give you. As I have said previously the only way you should have this type of jaw angle implant surgery is by the following guidelines:

1) You view an acceptable result as one that provides any improvement at all to your existing high jaw angles. I can provide no assurance that an 11mm vertical length will be ‘low enough’.

2) If you are seeking a specific target length or certain jaw look, as shown by model or other celerity pictures, and that is the only result that will make you happy…then you should not have the surgery. This is what custom jaw implants are used to create.

3) An understanding that there is a relatively high incidence of jaw angle implant asymmetry when using non-custom jaw angle implants that provide vertical lengthening. When half the implant needs to be positioned off the bone the difficulty in getting symmetry between the two facial sides escalates considerably over any other type of facial implant which is positioned entirely on the bone.

Dr. Barry Eppley

Indianapolis, Indiana