Author Topic: jaw/mandibular implants after adverse Mandibular contour post MMA  (Read 1209 times)

Dharma

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I have a hypoplastic right mandible d/t a motorcycle injury when I was young.  I just had MMA for sleep apnea associated with abnormal jaw growth as a result of this accident back in the day.  Fortunately, my surgeon did a great job on my tricky and delicate right osteotomy.  My left mandible looks and feels fantastic--the osteotomy site is smooth and looks good.  The right, as we expected, not so much.  We had discussed getting a mandibular implant to help contour my right mandible and fix my facial asymmetry (which really wasn't that noticeable until after MMA which made it quite obvious, unfortunately). 

I've heard that getting implants to address this after MMA or orthognathic surgery isn't all that uncommon.  I don't know much about it yet--I'm just beginning to look into it. 

Anyone have any experience/insight/tips? 

molestrip

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Re: jaw/mandibular implants after adverse Mandibular contour post MMA
« Reply #1 on: April 29, 2016, 09:01:09 AM »
Where did you hear that? It's generally only a problem with movements over 10mm+ or 9.7mm at the osteotomy (>12mm) and over the age of 30, according to a recent study. Who said you need implants? You can graft the gap with bone. It's actually a rare complication after a year, bones don't like discontinuities. Dr Wolford does an inferior border osteotomy to avoid the problem, which reduces the notch rate from 20% down to 5%. It also has the disadvantage of ligating the facial artery/vein, safe to do but all things being equal, better not to compromise blood supply to things. A&G use PRP grafts, I hear it doesn't work that well but they'd know better.

Dharma

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Re: jaw/mandibular implants after adverse Mandibular contour post MMA
« Reply #2 on: April 30, 2016, 12:53:08 AM »
Heyo,

I've read about it from others online and then some plastic surgeons I know were talking about it.  Its not to "fill" the gap between the osteotomies, its to smooth out or adjust the jawline contour around them.  My arch enemy, my mandible, is a little gimpish on the right (motorcylce injury) and the osteotomy, per my surgeon, was especially tricky  on that side to get a good break.  I now have funky looking jaw line as there is an angle change where the osteotomy was performed. This only happened on the right--my left mandible looks beautiful. 

Ligating the facial vasculature?!  Dr. W is fearless....