What Can Be One To Prevent A Custom Jawline Implant From Shifting?

Q: Dr. Eppley, I had custom jaw/mandibular angle implants installed by another surgeon. My right and left sides naturally had some asymmetry, the left a fair bit more deficient. The right implant worked out well, but the left came loose and shifted forward. The surgeon performed a revision on the left. He shaved it down a little bit and placed it once again, this time with bigger screws. But it looks like it has shifted a second time! The implant isn’t super ambitious in size at all so I’m wondering what my options are? Is it reasonable to try again? Should I go to a different surgeon? Is there anything else my surgeon can do to guarantee it doesn’t shift again? I’m quite distressed and I know Dr Eppley is a master of the field so I’m just looking for any answers or expertise he can share. I feel like I should have gone to him to begin with!

A:What you need to answer your question is three pieces of information to provide a qualified opinion:

1) Before and after patient photos

2) The original implant design file

3) a current 3D Ct scan of the lower jaw

Any comment or decision made on less than this information would be an uninformed one.

Dr. Barry Eppley

Indianapolis, Indiana