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Jaw Augmentation with Implants (Mandibular angle)

Jaw implants can be placed for a number of reasons the commonest are:

– For people who have had underdevelopment of the jaw and who wish to have a more defined jaw line.
– For patients with congenital asymmetry of the jaw.

 

What are jaw implants?

Mandibular angle implants are usually made from either medical grade silicone , from medpor or from PEEK, all materials have been commonly and successfully used in surgery form many years.

The implants are designed to fit directly onto the jaw and are commonly preshaped.orbital rim and are usually preshaped. Custom made implants can be obtained, if wished or considered necessary, although a CT scan of the bony structures is required before these can be constructed.

What are the alternatives to mandibular angle implants:

Non-surgical alternatives include the use of facial fillers, which are usually temporary.
Surgical alternatives to implants are either:
– Fat transfer, where some fat is harvested from another part of the body (usually abdominal wall or thigh) and transferred to the area needing augmentation.
– Jaw osteotomy procedures, usually orthognathic procedures to alter the occlusion as well as the shape of the jaw.
– Bone on-lay grafting, bone is harvested from the hip or the skull bone, shaped and fixed onto the jaw. Over time bone placed this way can gradually resorb.

How is the procedure performed?

Jaw implant placement is usually undertaken as a day case procedure under a sedation or general anaesthetic. A small incision is made in the mouth adjacent to the lower back teeth. The implants are placed directly onto the jaw and secured with 2- 3 small titanium screws to prevent any movement of the implants following placement. In order to place the screws, a small incision (approximately 5mm long) needs to be made in the cheek and this can leave a small scar. The wounds are closed with dissolving stitches.

Following surgery you can expect some soreness and some swelling. The initial swelling will settle over 7-10 days, however it will take a number of weeks for the swelling to finally settle and the new appearance to take shape.

What the risks and sequlae of surgery?

Initially following the surgery you can expect soreness swelling and tightness. This will settle with time. Other complications are unlikely but include, bleeding, infection, facial asymmetry, numbness of the lip and lower teeth and gums, which is usually temporary but can take a few weeks to fully settle.

Implant infection may mean the implant needs removal. If this occurs then you will need to wait until the tissues have healed before having another one placed. It maybe possible to palpate the edge of the implant under the skin if you have thin skin.

Post-operative instructions following surgery:

Your mouth needs to be kept clean and you will need to make sure that your oral hygiene is good following surgery. You are advised to brush your teeth normally, just taking some care in the area
where there are stitches. You will be given some mouthwash to take home which is antibacterial and should be used twice a day, morning and night. It is also of benefit to rinse following meals with hot salt water for the first few days while the wound is healing. You will be given a short course of oral antibiotics to be taken following the surgery and the course should be completed.

Bruising and swelling is normal and to be expected, the swelling will reach its worst at 3-4 days following the surgery and then gradually settle. You are advised to take a softer diet during this initial period of healing. I would advise 7-10 days off work following this surgery and you should avoid any strenuous sports for 4-6 weeks. Gentle exercising can be resumed 3-4 weeks after surgery.

You will be seen in clinic for follow up, one week, 8 weeks and 6 months following the surgery.

The Face Surgeons
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