Q: Dr. Eppley, I had jaw angle implants placed earlier this year and they are asymmetric. I can tell the left implant is way forward of where it should be but I think the right implant is a little forward of where it should be as well. With a revisional surgeryI am actually thinking about going up to the large implant as the medium doesn’t really add that much. Whatever is done, the implant MUST be placed correctly, that I know now. I had no idea jaw implants were so difficult to place correctly. I did ask my Doctor about the placement and he said it’s tough to place them further back because the muscles and tendons tend to push them forward. And he said that it’s not wise to attach the silicone implants with a screw because they are soft and can tear if there’s too much pressure from the muscles. I don’t know if he just made all that up or what to believe now. Do you use implants made of different material if you are going to attach them with a screw?
A:In all due respect to your surgeon, he/she is inaccurate on both assertions about jaw angle implants. To properly position jaw angle implants, muscle and tendons must be elevated to make the pocket. Not releasing these attachments will result in the implant being positioned too far forward. Secondly I screw in every jaw angle implant and 95% of what I put in is silicone. Screws will not tear or disrupt the implant. Without securing them in with a screw the risk is high that they will become displaced or moved from the position/pocket that is made for them.
Dr. Barry Eppley