What Is The Best Method To Lengthen My Lower Jaw Using My Own Bone?
Q: Dr. Eppley, For a long time i have been very insecure about a few aspects of my jaw. For one i have quite a short vertical jaw (or lower third of the face ) length which looks bad compared to my forehead which is much longer. At first i had considered forehead reduction but I already have a very small face compared to my body and don’t wanna make it worse.)
So I really want a vertical lengthening of my jaw. BUT i do not want any implants. So I’ve browsed the internet for months now looking for a solution that uses just bone to fix my problem and I think I might have found a couple. But I don’t know if these are possible and if any surgeon will help me with them.
So I read alot online about it being possible the create a gap between two bones,and that bone would regenerate between the gap eventually filling in the gap, is this true? I’ve also read that in some instances a bone graft material can be used to fill in the gap which will eventually become normal bone, is that also true?
My ideas of what could possibly be done :
idea number 1 :
a cut alongside the entire jawline is made, below the important nerves, much like the cut in a full chinwing osteotomy, of which ive provided a picture, the cut off bone is then moved 5 to 10 mm vertically ( downwards ) and put together with screws and plates to hold it in that place, from here, either the bone would regenerate ( as seen in the second picture ive provided ), filling the gap, or perhaps bone graft material could be used. this should eventually leave me with a vertically longer jaw that is completely natural bone material.
idea number 2 :
starts off the same, a cut alongside the entire jawline, but instead of a clean horizontal cut, the cut is like the one done in standard jaw surgery, where they slide the jaw forwards if you have a receding lower jaw, in this cut, they cut the bone in a way that they can slide it outwards without there being an open space between the cut. could this cut also be performed vertically along the jawline? so that it can be slid downwards without it creating an opening between bone.
idea number 3 :
if none of the above is possible, could a distraction osteogenesis of any kind perhaps be performed? ( picture provided ) i assume this has never been done for vertical length gains before, as i cant seem to find any evidence of that, but would it be possible ?
even thought you can find alot on the internet, its very hard to know what is real and what not, and if real, how well known and used the techniques are. so i really wanted to ask a professional .
I really hope you can help me, because to be honest, i seem to get more and more anxious by the day about this topic. i know that in the end none of this means the end of the world. but it is affecting my life quite a bit. and has been for a couple of years now.
thank you very much for your time! i hope to hear from you.
A: The only two viable options you have are a chin wing osteotomy, which is only going to get 5 to 6mms vertical lengthening or a vertical lengthening chin osteotomy which can easily get 10mms. Ideas # 2 and #3 (distraction osteogenesis) are not viable aesthetic options for a variety of reasons.
Dr. Barry Eppley
World-Renowned Plastic Surgeon