Jaw Angle Implants

Q: Dr. Eppley, I have a question about the jaw angle implants that worries me, I consulted a few Maxillofacial surgeons in my country. Some of them said to me that implants under the masseters muscles (for aesthetic reasons, not deformity corrections) is a bad idea, one of them even called jaw implants malpractice. The main argument is that due do the fact the those are the strongest muscles in the body and are constantly active (and mine are even hypertrophied) and will apply constant pressure over the implants, sooner or later it will lead to complications, that the main of them is bone erosion which will lead to relapse at the the best or more severe bone loss at worse.

I’v also been told:

– The procedure is quite aggressive and the masseteric muscles never recover completely from it.

– The procedure will cause mouth closing/ opening problems and chewing problems. 

– The scar tissue that will created from the procedure will add 5 mm~ of width to both sides of my face, which will lead to an unaesthetic result, even if the implants will designed for vertical length only.

– The implants will cause thinning of the masseters over time, which will cause further health complications (I don’t remember specifically).

I would appreciate your reply to those concerns. Is the procedure really that dangerous? 

A: The simple answer to almost everyone of your jaw angle implants concerns is that none of them are true or are based in any biologic or clinical reality. While it is true that jaw angle implants are placed under the masseter muscles, this does not lead to chewing or muscular dysfunction, underlying bone erosion, or aesthetically undesireable scar tissue formation. The only negative masseter muscle issue that I have ever seen, and it is an aesthetic one is that the pterygomasseteric sling can be disrupted if one is not very careful in their placement. This can lead to bulging above the jaw angle when biting down as opposed to the bulge being over the jaw angle point normally. Other than this potential issue I have found having placed, modified and removed many jaw angle implants that they are as safe and effective as any other type of facial implant.

Dr. Barry Eppley

Indianapolis, Indiana