Will Jaw Angle Implants Help After Jaw Advancement Surgery?

Q: Dr. Eppley, I had a bimaxillary correction surgery last year. After the surgery I’ve lost my jaw angle.My jaw angle was near 90 degree.I have before-surgery-x-rays and want it back,but I’m worried if that doesn’t look good on me. I heard that you prefer silicone with a 3D custom implant fabrication. Would that be slippery? (compared to medphors) In my case,I only need a verical lengthning (a lot).

A: It is not rare that orthognathic surgery, specifically sagittal split ramus osteotomies, change the shape of the jaw angles. This can be due to an actual change in the jaw angle bone shape with advancement movements, loss of masseter muscle mass or both. It can also occur in short jaws where the jawline and chin move forward but the jaw angle position remains high, thus causing an illusionary change in the jaw angle shape. Regardless of the cause, restoration of the jaw angle can be done using jaw angle implants. You specifically have pointed out the dimensional change needed which is vertical lengthening. Of the available off the shelf preformed jaw angle implants, vertical lengthening styles are available in either silicone or Medpor materials. Either type of vertical lengthening jaw angle implant is secured into position by a screw which is important when half of the implant is placed below the level of the bone. Depending upon asymmetry issues, which may occur after mandibular advancement surgery, a custom implant approach may be preferred to create the most optimal symmetry between the jaw angle sides. If one is concerned about how lower and more prominent jaw angles may look, computer imaging can be done to help with that assessment. I would need to have some pictures of your face to do that computer imaging assessment.

Dr. Barry Eppley

Indianapolis, Indiana