Q: Dr. Eppley, I had jaw angle implants and they appear to be asymmetric. My gut feeling was that the implants were not placed correctly. I could see quite precisely where each implant was. It is beyond my comprehension how my doctor (or any doctor who does this procedure) could not know how to correctly place the implants. My fear going into the surgery was that the final result might look quite good, but possibly be a little more or little less augmentation than I was wanting and that I would have wished that I had gone with a larger or smaller implant. Many plastic surgeons don’t do jaw implants so when I found one who did I just figured he would have the training and experience to know how to do it. And they did show me some before/after photos of a couple jaw implants they did. One guy was young like me and had an excellent result so I figured I would too.
As far as fixing this, how difficult is it to go in and reposition it correctly and attach it with a screw? I also must say that I am considering going up to a large. I held the medium implant in my hand and it seemed like it would provide a lot of augmentation, but in reality it doesn’t. I was worried the medium could actually be too much, but now I actually think I need a bit more than what the medium gives. When you do the revision jaw angle implants surgery can you just remove my current implant and then put in a large implant (correctly) in one surgery? Or if I stick with the medium can you go in and just reposition it correctly and attach it with a screw?
A: I think you are being a little harsh in your surgeon. Jaw angle implants are hard to do and implant asymmetry is not rare. I have a tremendous experience doing this type of facial implant surgery and it will occasionally happen to me as well despite my best efforts. The overall need for jaw angle implant revision surgery is about 15%. Whether you keep you existing jaw angle implants or go up a size, the effort is the same to reposition it and screw it into place.
Dr. Barry Eppley
Q: Dr. Eppley, I’ve had saline breast implants for approximately 19 yrs. One has recently deflated. I am wanting to see what my options are as far as saline or silicone replacement.
A: You have gotten good use out of the original breast implants as most saline implants from twenty years ago did not last this long. The options for managing a saline breast implant deflation (saline breast implant replacements) are three fold. First you could just replace the deflated implant which would be the simplest and most economical option. But at nearly twenty years out the opposite breast implant is running on borrowed time and most people would be concerned that the other implant would deflate shortly after the replacement surgery. Thus most women are going to opt to replace both implants which could be either saline (option #2) or switch to silicone gel implants. (option #3) Whether one elects to stay the same size, go bigger or go smaller can be done with either saline or silicone implant replacements. There are arguments to be had for either choice but many women would choose silicone replacements so they would never have another implant deflation in their lifetime. A few women given the long-term success and lack of any problems until the deflation many opt to keep saline filled implants.
Dr. Barry Eppley