Which One Is Better For Me – Orthognathic Surgery or Custom Facial Implants?
Q: Dr. Eppley, I notice a lot of wraparound jaw implant cases from your practice. I myself am looking into jaw and chin augmentation and was wondering what justifies recommending jaw implants over orthognathic surgery besides the respective recovery periods? Are the transformations in appearance generally not as drastic with orthognathic surgery alone? Are implants primarily to place patients within normal cephalometric discrepancies or are they more to do with patient esthetics? Does an objective improvement in the jaw always positively correlate with being in normal ranges based on ceph tracings?
A: There are major differences in aesthetic outcomes and indications for surgery between orthognathic surgery and facial implant augmentations which primarily include the following:
1) Orthognathic surgery is first and foremost a functional operation whose primary goal in most patients is occlusal correction. Any aesthetic benefits are byproducts of that effort.
2) Equally important is that orthognathic surgery mainly affects the sagittal plane, it can not create width or specific definition to the face/jawline beyond that of chin projection.
3) Custom facial implants of the facial thirds produces far more dramatic aesthetic changes than orthognathic surgery that are highly controllable.
4) In custom facial implants cephalometric evaluation/norms are irrelevant. While it is a bone-based procedure the whole intent is what effect it has on the external soft tissues. Thus patient aesthetics rule.
In short, orthognathic surgery and custom facial implants are not comparative operations nor are they interchangeable. Both are done for different reasons with non-comparable aesthetic outcomes.
Dr. Barry Eppley