Jaw surgery with pre-existing facial implants?

[Loneez]

Hi everyone,

This is an usual question, but I'm hoping that someone will have some insight... Scroll down if you want to get right to the question. The following paragraphs are my history and how I got to where I am today.

Some background. My parents are pretty old school, and when I brought up having jaw surgery when I was 16/17, they vehemently forbade it (for whatever reasons). I have an overbite, small jaw, and recessed chin - the classic mouth breather appearance. In addition to the functional consequences (I have sleep apnea and chronic migraine headaches - both of which have gotten worse over the years), the cosmetic consequences were really devastating. I think many of you can relate to the emotional toll of living with a skeletal facial deformity (which is truly what it is) - it really makes you feel like crap.

Well, when I was 18, I did something pretty drastic. In my mind, the jaw surgery ship had sailed, but I still had the chance to improve my facial appearance. I went to a plastic surgeon and asked him what I should do; he recommended cheek implants, a chin implant, and jaw implants. He gave me a great price and filled my head with promises of beauty and normalcy; that same day I booked the surgery and paid in full (I had tens of thousands of dollars saved due to a very lucky investment I had made a few years prior... I was really into finance (and am now studying it at college) and did things like that).

Surgery came and went, and it was absolutely life changing. I looked good. I felt good. My self-esteem was like night and day. I was so happy that I went through with it. Even my parents (who were initially shocked) came around after realizing how much happier I was and admitted that they were glad I had the surgery. And in case you're wondering, I told my mother I was having a rhinoplasty. My nose is crooked and has a bump, so it was pretty believable. When she came into the post-op recovery room and saw my new face for the first time (which was pretty much swollen everywhere except my nose), she went white. But still, I knew in my heart that I did what needed to be done in order for me to live a happier life.

A few years went by, and everything continued to be great. Except things weren't actually so great. Functionally, I still had all of the problems of a recessed jaw, and they were getting worse as the years went by. I finally decided to make an appointment with an orthodontist, and he more or less told me that I can, should, and need to have double jaw surgery to correct my functional issues and prevent more issues from appearing in the future.

So... jaw surgery is now back on the table. I am both stunned and shocked that it came up again after so many years. But it is what it is. I'm worried that if I don't do something now, I'll end up needing an even more invasive surgery in the future.

So far I've visited one maxillofacial surgeon to discuss this. He thinks he can do the surgery around the jaw and cheek implants, though he's not sure if the chin implant will have to come out or not.


My question to all of you is: did anyone have facial implants prior to jaw surgery? Or know anyone who did? Do any of you know the risks associated with having facial implants prior to jaw surgery? Absolutely any insight and thoughts would be greatly appreciated.


Also, I want to add the while the chin implant can safely come out, removing the cheek and jaw implants wouldn't be quite as simple. They're screwed in and fused to the bone and surrounding tissues; their removal would absolutely devastate my face. Considering this, I've decided that I want to do everything in my power to keep them in place.

[Rikenen]

What are your functional issues ?

[Loneez]

What are your functional issues ?

Mostly breathing issues. Sleep apnea, mouth breathing/diffculty breathing, teeth not properly aligned which apparently can cause more problems in the future, migraine headaches, overbite.

[meepmeepmeep]

my guess is that the jaw implants would have to come out and maybe custom implants could be placed a year later. the cheek implants probably wouldnt need to be removed depending on if they are placed high enough. the chin implant, i'm not sure but probably removed since your entire jaw will be in a new position which may cause the jaw implant to be oriented in a bizarre way if left as is. maybe you would be better off just taking it out and doing a genioplasty at the same time as jaw surgery.

anyway, it is kind of nice to hear a story about someone having a really positive outcome from just implants, even if they didn't take you all the way to where you need to be. good luck!

[Loneez]

my guess is that the jaw implants would have to come out and maybe custom implants could be placed a year later. the cheek implants probably wouldnt need to be removed depending on if they are placed high enough. the chin implant, i'm not sure but probably removed since your entire jaw will be in a new position which may cause the jaw implant to be oriented in a bizarre way if left as is. maybe you would be better off just taking it out and doing a genioplasty at the same time as jaw surgery.

anyway, it is kind of nice to hear a story about someone having a really positive outcome from just implants, even if they didn't take you all the way to where you need to be. good luck!

The red is where jaw implants are when placed. The surgeon said he could probably work around them when doing a BSSO. Why do you think they would have to come out? Though I agree that the chin implant will have to be removed.

Also, thanks for the insight!

[meepmeepmeep]

i just figured the jaw implants would be in the way for the bsso. if the surgeon said otherwise i would definitely trust his opinion over mine

[stupidjaws]

first person to talk positveley about implants! could you share before afters!? who was your dr?

[Vic]

Sorry to say but If you're having jaw surgery and already have implants, you'll have to have them taken out first then put back in a few months down the line once you've healed

[Loneez]

first person to talk positveley about implants! could you share before afters!? who was your dr?

I can't post photos for privacy reasons, but I PMed you my doctor's name. I'm surprised people here haven't had good experiences with implants... my surgery was very transformative.

[Loneez]

Sorry to say but If you're having jaw surgery and already have implants, you'll have to have them taken out first then put back in a few months down the line once you've healed

Why do you say this? Speculation or confirmed by personal experience?

[Vic]

Just a fact mate. For the surgeon to be able to get the mandible to make the cut, they have to strip off the Masseter muscle first and there's no way they can do that with a jaw implant in the way. They will also need to remove the screws which are holding the jaw implants in place to make the cut in the bone and also put new screws in to hold the bone together. They might even say that they need the holes to heal where the implant screws went in before performing the jaw surgery, so you might have to have the implants removed first then a few months later have the jaw surgery, but your surgeon will be able to advise you on this by looking at your CT scan

[earl25]

What material are your implants

[molestrip]

Oh man, that surgeon was a douche. Those guys are trained in jaw surgery too and should have known you were getting the wrong treatment. I would opt to remove the chin and mandible implants, you don't want them there long term anyway and they probably won't last another 70+ years that you need them there. When you do jaw surgery, you don't want your surgeon compensating around them and you don't need the extra infection risk and more holes in the bone. The cheek implants should be ok, I wouldn't recommend them but they're already there and you can remove or replace them in a few decades when they cause problems.

I had the same issue with jaw surgery btw. My bite opened up in college, parents took me to surgeon for consult. Surgeon told me all these problems I'd have (and have had) and I said let's go. My mom freaked out and said this is major surgery and I shouldn't rush into it. I was like 19 then so naturally I internalized my mom's reaction and committed to myself to just live with the open bite. I didn't even think of it again until the sleep apnea stuff was causing me major problems and then at some point I was able to connect the two. Just.. f**k the whole medical community for doing this s**t to us. These are well understood problems that should be easy to diagnose and treat and this point, it's ridiculous that people like us are bouncing around the system because there's so many of us!

[Loneez]

This pls.

What material are your implants

Silicone

[Loneez]

Oh man, that surgeon was a douche. Those guys are trained in jaw surgery too and should have known you were getting the wrong treatment. I would opt to remove the chin and mandible implants, you don't want them there long term anyway and they probably won't last another 70+ years that you need them there. When you do jaw surgery, you don't want your surgeon compensating around them and you don't need the extra infection risk and more holes in the bone. The cheek implants should be ok, I wouldn't recommend them but they're already there and you can remove or replace them in a few decades when they cause problems.

I had the same issue with jaw surgery btw. My bite opened up in college, parents took me to surgeon for consult. Surgeon told me all these problems I'd have (and have had) and I said let's go. My mom freaked out and said this is major surgery and I shouldn't rush into it. I was like 19 then so naturally I internalized my mom's reaction and committed to myself to just live with the open bite. I didn't even think of it again until the sleep apnea stuff was causing me major problems and then at some point I was able to connect the two. Just.. f**k the whole medical community for doing this s**t to us. These are well understood problems that should be easy to diagnose and treat and this point, it's ridiculous that people like us are bouncing around the system because there's so many of us!

What type of issues should I expect from these implants? And when will they start arising? From everything I've read silicone implants are extremely well tolerated long term. There might be some issues with bone remodeling, but that's usually inconsequential.