What Is The Best Procedure To Get My Chin/Jaw Looking More Normal From Juvenile Rheumatoid Arthritis?
Q: Dr. Eppley, My jaw stopped growing at a young age due to Juvenile Rheumatoid arthritis. I would really like to get my chin and jaw to look more normal. I am not sure what procedure or procedures I will need. Thank you for answering back with the cost of the custom jaw wrap implant. I was on the website and saw pictures of patients that had genioplasty and chin implants. I’d like to know which would be best. If genioplasty and implant would be best, I’d like an approximate cost for everything. Thank you!
A: Thank you for your inquiry and sending your profile picture. When you have a skeletal jaw foundation that is so short from a congenital/medical basis the first question is whether you are a candidate for orthognathic surgery. (double jaw surgery with lower jaw advancement) That is not a question that can be fully answered by looking at a picture. This requires a full orthodontic evaluation/workup which you may or may not have had. In an ideal world this is likely the best approach for your severe lower jaw deficiency.
Any ongoing comments are based on the premise that orthognathic surgery is not option you are going to pursue and a ‘camouflage’ approach to the problem is being taken. (and one accepts their bite the way it is now) Thus a sliding genioplasty is the chin procedure you should have and it would like be of the jumping man variety. This is certainly the one basic procedure that would be of greatest benefit. An implant alone is not a good option for your chin as it is simply too deficient. There could be an option for an implant on top of the sliding genioplasty but never an implant alone.
The rest of the jawline, while having to be done with an implant approach (as there is no other way to do it), is going to likely require a custom jawline technique as the anatomy of your ramus and body of the mandible is undoubtably not normal and is most likely asymmetric as well.
Dr. Barry Eppley