Author Topic: Gunson’s Mandibular Angle Implants  (Read 4239 times)

Ramalito

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Gunson’s Mandibular Angle Implants
« on: July 31, 2018, 04:05:07 AM »
I was considering jaw surgery 2 years ago because my lack of mandibular angle makes my jaw look steep. My bite isn’t perfect but looks good, I have a nice smile/teeth. People on this forum told me not to get surgery and after reading about some of y'alls complications I realized you guys were right. HOWEVER I am hell bent on getting a nice jawline.

Jaw angle implants seemed like easiest way to achieve that but i’m not sold on Yaremchuk, Eppley or any of the doctors I researched. Plus the risk of infection is higher than I would like.

While researching jaw implants I came across Gunson’s website and thought their facial contour grafting sounded interesting:

“Our technique uses a combination of hydroxyapatite granules with collagen and water which is then heat treated. The implants are customized for each patient and their needs at surgery. The hardened material can then be used for malar grafts, nasal base grafts, mandibular angle grafts, etc. In our published study of 860 implants, we showed the implants to be safe, efficacious, and biocompatible.”

I emailed them asking If the results of their customized HA implants are similar to regular jaw angle implants. The answer was yes. That it is possible to get a very nice result with mandibular angle grafts and that they sometimes do them in conjunction with jaw repositioning surgeries.

Sounds great to me. Why is this procedure not that common then?
« Last Edit: July 31, 2018, 06:09:50 AM by Ramalito »

RedFountain

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Re: Mandibular angle grafts (Gunson)
« Reply #1 on: July 31, 2018, 04:39:04 AM »
Have you seen results? I haven't, but I can imagine them to be sub-par. From what I've seen so far, HA grafting usually results in lumpy, unaesthetic and undefined shapes. Might be suitable for female cheeks or something, but I'd be wary off such an approach on my gonial angles

Ramalito

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Re: Mandibular angle grafts (Gunson)
« Reply #2 on: July 31, 2018, 05:41:36 AM »
From what I gather hydroxyapatite comes in 3 forms: Injectable, paste, and solid implant. I suspect you can achieve a smoother look with solid implants. Gunson mixes HA with collagen to make them. Is that the norm?

This guy looks pretty good https://www.realself.com/review/melbourne-au-cheek-augmentation-chubby-droopy-face-weak-facial-bones#media-review-1729261-image-785741
« Last Edit: July 31, 2018, 05:50:15 AM by Ramalito »

kavan

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Re: Gunson’s Mandibular Angle Implants
« Reply #3 on: July 31, 2018, 08:56:01 AM »
Ramalito,

Jaw surgery as in 'maxfax' just to decrease either the steepness of the mandibular plane and/or increase the jaw to jaw distance is not the best option because it's not a 'given' that it will decrease the steepness as much as you would like or increase the jaw to jaw distance as much as you would like.

Whether or not HA augmentation done DURING a surgery, would be 'same/similar' as that of an implant would depend on whether or not the implant you would need was actually WITHIN the LIMITATIONS of what HA augmentation could achieve. In general, HA augmentation is limited to being on the MODEST side whether it be HA 'paste' (mainly for filling in DENTS) or HA 'granules' (HA mixed with COLLAGEN). The latter being the type know docs CONVERSANT in HA augmentation use such as Gunson and Mendelson who's RS link of a patient you gave. So, both of those doctors are quite responsible as to reserve HA augmentation to appropriate candidates who are indeed within the realm of MODEST augmentation with those materials. 'Sloppy or lumpy' looks are associated with use of HA augmentation basically EXCEEDING the LIMITATIONS of what it can do. Basically, when docs use the HA PASTE meant for filling in dents and dingies and use it to AUGMENT where the augmentation is meant to be MORE than 'modest'.

As to what HA augmentation could NOT do, whether it be 'paste' or 'granules' would be that it would not give you a WIDE jaw to jaw distance (IF you actually needed that.). It would not give you a 'drop down' to the back of your jaw either because the material is meant to be an OVERLAY and not something to extend a deficient area DOWNWARD.

HA augmentation with HA GRANULES is good for modest augmentations and the 2 doctors you have mentioned would be responsible enough to tell you if your goals were within the limitations of what the material could do. To the best of my knowledge, Gunson puts in DURING main maxfax surgery (but not as sole procedure). But other doc puts as a sole procedure.

That said, you can't rule them out based on someone 'imagining' them to be subpar and/or because he/she may have seen poor results when HA paste was used irresponsibly in act of exceeding what the material can actually do. But if you want to rule them in, you need to determine whether or not you are actually a candidate for MODEST augmentation with them. One way would be to consult with the doctors you came across who do them.

As to why HA augmentation is not more 'COMMON', it would be because it's often not a stand alone procedure and done when a maxfax surgery is also done and/OR when it is done AS a stand alone procedure, it is reserved for MODEST augmentations.

Jaw implants are more 'COMMON' because they are often associated with SIGNIFICANT augmentations where the aim is to 'drop down' as to extend the back of the jaw DOWNWARD and to also increase the jaw to jaw distance.
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Ramalito

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Re: Gunson’s Mandibular Angle Implants
« Reply #4 on: August 01, 2018, 04:10:03 AM »
First of all, I want to thank you Kavan for taking the time to answer my question in such detail. You are obviously very knowledgeable in the subject.

My jaw has a slight depression on both sides, at a 3/4’s angle it’s when I notice it the most (first pic). While regular jaw implants are associated with significant augmentation and can be life changing sometimes, they are too risky in my opinion. I rather get a modest augmentation the “safe” way.

Fillers are less invasive but too expensive for a temporary solution.
« Last Edit: August 01, 2018, 04:21:21 AM by Ramalito »

kavan

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Re: Gunson’s Mandibular Angle Implants
« Reply #5 on: August 01, 2018, 06:37:09 AM »
First of all, I want to thank you Kavan for taking the time to answer my question in such detail. You are obviously very knowledgeable in the subject.

My jaw has a slight depression on both sides, at a 3/4’s angle it’s when I notice it the most (first pic). While regular jaw implants are associated with significant augmentation and can be life changing sometimes, they are too risky in my opinion. I rather get a modest augmentation the “safe” way.

Fillers are less invasive but too expensive for a temporary solution.

Thanx can be done by hitting 'applaud' to my profile.

OMG. Your jaw is BEAUTIFUL. Don't get implants to it and don't get maxfax for that minor thing. You are a filler 'case'. Filler easier and cheaper to REVERSE than maxfax surgery or the implants, both of which you should avoid pursuit of.
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strongjawman

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Re: Gunson’s Mandibular Angle Implants
« Reply #6 on: August 01, 2018, 08:12:46 AM »
Thanx can be done by hitting 'applaud' to my profile.

OMG. Your jaw is BEAUTIFUL. Don't get implants to it and don't get maxfax for that minor thing. You are a filler 'case'. Filler easier and cheaper to REVERSE than maxfax surgery or the implants, both of which you should avoid pursuit of.

Second this. You look amazing (at least your lower third!); don't risk your natural beauty.

Ramalito

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Re: Gunson’s Mandibular Angle Implants
« Reply #7 on: August 01, 2018, 10:02:27 AM »
Wow thank you Kavan and Strongjawman. It’s hard for me to believe that though, I’ve disliked my jaw since I can remember.

When I first discovered that injecting fillers in the jaw was a thing, I was over the moon... until I saw the price tag. Dropping 4K every 6 months is crazy!

Lestat

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Re: Gunson’s Mandibular Angle Implants
« Reply #8 on: August 01, 2018, 10:44:14 AM »
I disagree with kavan and strongjawman. Personally I dont like your jaw. Your mandibular angle is to high. I recommend you jaw angle implants (made of peek).

Ramalito

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Re: Gunson’s Mandibular Angle Implants
« Reply #9 on: August 01, 2018, 10:55:36 AM »
100%

I feel more comfortable going to Gunson even if his results are not as dramatic as Eppley’s. I’ll take any improvement I can get.
« Last Edit: August 01, 2018, 11:08:56 AM by Ramalito »

strongjawman

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Re: Gunson’s Mandibular Angle Implants
« Reply #10 on: August 01, 2018, 12:21:47 PM »
I disagree with kavan and strongjawman. Personally I dont like your jaw. Your mandibular angle is to high. I recommend you jaw angle implants (made of peek).

There isn't a one size fits all for what is beautiful. There are common prevailing themes e.g. symmetry, forward growth, skin quality, teeth and PROPORTIONS etc etc.

Not everyone will look good with the same lowered ramus just because of the archetypal idea of beauty, as it is only one piece to a larger puzzle. How everything fits together and compliments the entire face is much more important, and changing one thing might not always be the best outcome. I think the lowered ramus in your second photo looks ridiculous and the first looks better from those two pictures.

Look at this model; her ramus is quite high and she looks stunning





Look at a young Julia Roberts too; good forward projection but shortish ramus of mandible.

It's up to you but just giving my two cents.

kavan

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Re: Gunson’s Mandibular Angle Implants
« Reply #11 on: August 01, 2018, 03:13:50 PM »
Wow thank you Kavan and Strongjawman. It’s hard for me to believe that though, I’ve disliked my jaw since I can remember.

When I first discovered that injecting fillers in the jaw was a thing, I was over the moon... until I saw the price tag. Dropping 4K every 6 months is crazy!

You would have to establish the actual volume needed to know the price and to experience 1 bout to estimate the time it lasts. That would allow refill estimates--costs thereof.
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kavan

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Re: Gunson’s Mandibular Angle Implants
« Reply #12 on: August 01, 2018, 03:39:07 PM »
I disagree with kavan and strongjawman. Personally I dont like your jaw. Your mandibular angle is to high. I recommend you jaw angle implants (made of peek).

Just WTF exactly do you disagree with. I hope it's not my very timely thought out initial explanation given before she posted photos. IF that's what you disagree with I would be disinclined to spend much to any time at all EXPLAINING my REASONING to posters with someone like you just interjecting little more than your aesthetic opinion. So clarify what you 'disagree' with (which post).

IF it's my aesthetic opinion (that she had a nice jaw line) after seeing her photos, you could have just offered YOUR opinion in absence of of any mention of disagreement.

What you just did was discount the opinions of others WITHOUT giving ANY reasoning other than your personal preferences which was an opinion you could have given without having to disagree with anyone who gave one prior.

What I can do is refrain from giving the OP any more opinions/information from me and assign all opinions or information thereof to YOU. As mentioned I'm disinclined to expend much effort and/or share much information if all it takes is someone like you to throw the baby out with the bathwater based on your personal opinion.
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kavan

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Re: Gunson’s Mandibular Angle Implants
« Reply #13 on: August 01, 2018, 03:43:06 PM »
There isn't a one size fits all for what is beautiful. There are common prevailing themes e.g. symmetry, forward growth, skin quality, teeth and PROPORTIONS etc etc.

Not everyone will look good with the same lowered ramus just because of the archetypal idea of beauty, as it is only one piece to a larger puzzle. How everything fits together and compliments the entire face is much more important, and changing one thing might not always be the best outcome. I think the lowered ramus in your second photo looks ridiculous and the first looks better from those two pictures.

Look at this model; her ramus is quite high and she looks stunning







Look at a young Julia Roberts too; good forward projection but shortish ramus of mandible.

It's up to you but just giving my two cents.

You are correct to offer your REASONING.
Please. No PMs for private advice. Board issues only.

ditterbo

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Re: Gunson’s Mandibular Angle Implants
« Reply #14 on: August 01, 2018, 07:26:59 PM »
To OP: if that gonial angle is a 'problem' for you, I don't see it in the pic. It's not detracting from your looks in any serious way. Do you not like how you look as a whole or that it? Are you an actor or model? You seem to be extremely attractive from what little we saw, no need to fix this esp because of the s**tty options out there.  I agree try filler before anything else. I'm actually curious about it myself, while I pray for some miracle in TMJ tech and/or doubling of my income.