Q: I have a very high jaw angle. My goal is to have a jaw implant that will lower my jaw angle as much as possible. The problem is that the biggest implant I have seen only has 35mms of vertical length and the inferior ridge is just under 10mms. Does a bigger jaw angle implant exist and I have just not seen it? If not, how can a bigger one be made if possible?
A: Your are correct in your assessment that no off-the-shelf jaw angle implant can drop one’s angle down anymore than 10mms at most. Anymore more than that requires a custom implant to be made which can bring it down closer to 20mms. Such exceptional jaw angle extensions are uncommonly requested or needed which is why no stock implant exists with that degree of accentuation. I have made custom jaw angle implants that do achieve what you are after. They require a jaw model to first be made which is done from a 3-D CT scan of the patient. The jaw model made is then the exact anatomy of the patient from which the design and model are created.
Dr. Barry Eppley
Q: With all of the jaw angle implants that you have placed, what are the most common complications? What problems have you see long-term? Are they permanent or would I need another in future?
A: Jaw angle implants, in my experience, are uniquely different than all other types of facial implant locations. Because they are put under the biggest muscle in your face (masseter muscle), and the only facial muscle that actually moves a bone (mandible, lower jaw), there is more discomfort and recovery from the procedure than any other facial implant procedure. The sides of the jaws are fairly swollen and the mouth will not open normally for a few weeks. (trismus) This is due to the stretching and trauma to the masseter muscle. Because it is a large implant that is put in through the mouth, the risk of infection seems to be higher than any other facial implant. Despite doing every infection precaution available, I have found that the infection rate is about 5% of all patients implanted, necessitating removal and/or replacement. The other complication risk is asymmetry. Because the implants are on opposite sides of the face, it is challenging to always have a perfectly symmetric result. (many patients don’t have jawbone/angle symmetry to start with) This leads to a revision rate for symmetry correction in jaw angle implants of around 5% also. Collectively, this means that one out of every ten jaw angle implant patients will need some sort of revisional surgery. These complications are seen early within the first few weeks to several months.
On the good news side, jaw angle implants are permanent and will not change over one’s lifetime once successfully implanted amd healed into place.
Dr. Barry Eppley
Q: Thank you for reviewing my photos and my desire to make some facial changes, particularly that of my jaw line. In looking at your computer imaging predictions, the jaw angle implants seemed to have lengthened my jaw angles quite a bit in the side view. I like the shape of my jaw for the most part and was looking mainly to add width from the front view. I know there’s only certain jaw angle implants available so would that be possible or even advisable? Also, do you think I’m a candidate for chin implants? I’m now thinking those may help as well.
A: Thank you for your comments on the computer imaging as that clearly tells me what the right style of jaw angle implant/change that you desire. The one I depicted was the style known as an inferolateral jaw angle implant which does just what you have described and seen, it makes the jaw angle longer and wider simultaneously. Having seen that you have described and preferred what is known as the other jaw angle implant style which exists known as a lateral projection or width only style. That is a very distinct jaw angle implant style and is easier and less traumatic to place as the tissues at the lower border of the jaw do not have to be stripped off to place the implant.
As for chin implants, there are a half dozen styles that make different chin dimensional changes. What type of chin change do you think you would like? That helps in selecting the best type of chin implant style for you.
Dr. Barry Eppley