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Patient Examples facial implant surgery - lower face implants
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mandible (jaw) implants
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Three groups of patients benefit from implant augmentation of the mandibular body, angle, and ramus. These include patients with normal, deficient, or surgically altered anatomy.
Most patients who desire mandible augmentation have lower face horizontal dimensions that relate to the upper and middle thirds of the face within a normal range. These patients, usually males, perceive a wider lower face as desirable. This group benefits from implants designed to augment the ramus and posterior body of the mandible and, in so doing, increase the bigonial distance. Other patients desire more definition and angularly to the mandibular border. Implants which augment the anterior mandible back to the ramus can achieve this.
Another group of patients who benefit from mandible augmentation are those with skeletal mandibular deficiency. The majority of these patients (approximately 80 percent) can have their Class II (overbite) dental relationships normalized through orthodontic tooth movement. The remaining 20 percent, or 1 percent of the total population, have mandibular deficiency that is so severe that surgical mandibular advancement would be needed to correct it.
For these patients with corrected occlusion, alloplastic augmentation of the mandible can provide a visual effect similar to, and, in my opinion, superior to that of sagittal osteotomy with advancement employing an outpatient surgical procedure that avoids any further dental manipulation. The anatomy associated with mandibular deficiency, which can be camouflaged with implants, includes the obtuse mandible angle with steep mentocervical angle, as well as the decreased vertical and transverse ramus dimensions. The addition of an extended chin implant will camouflage the poorly projecting chin.
A third group of patients who may benefit from alloplastic augmentation of the mandible are patients who have had their Class II dental malocclusion due to mandibular deficiency corrected by sagittal split osteotomy with advancement of the distal segment. It inevitably creates a contour irregularity at the site of the body osteotomy and distal segment advancement. It may also result in an aesthetically displeasing position of the ramus angle with insufficient height, insufficient width, or asymmetry Mandible implants, often combined with chin implants can be used to improve contour in these patients. Clinical examples of these uses for mandible implants are shown below.
Implants which augment the lateral mandible can increase the width of the lower face in patients who desire a stronger look to their jaw. Two examples of patients who underwent mandibular (jaw) augmentation to increase the width of their lower face are shown below.
An explanatory video of the mandible (jaw) augmentation procedure.
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patient example 1
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patient example 2
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patient example 3
When used in combination with chin implants, congenitally small mandibles can be brought to more normal dimensions. This operation can benefit patients who have their malocclusion due to mandibular deficiency corrected with orthodontics alone rather than orthognathic surgery. These patients are left with a normal bite but with small mandibles. The third patient on the left is shown before and after the augmentation of her mandible and jawline with mandibular and chin implants.
To see how combining mandibular and chin implants can mimic the appearance obtained after mandibular osteotomies click here.
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patient example 4
This patient desired a prominent chin and mandibular contour. Seven previous surgeries had not been effective. Two procedures, including a removal of previous placed implant, submental lipectomy, and placement of chin and mandibular angle implants, were performed.
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patient example 5
This patient with Treacher Collins syndrome had undergone sliding genioplasty in the past. Chin and mandibular implants were placed.
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patient example 6
This patient underwent removal of a previously placed chin implant, replacement with a better contoured and positioned chin implant, as well as mandibular body and angle implants.
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patient example 7
Sagittal split and horizontal osteotomies (sliding genioplasties) of the mandible leave irregularities along the border of the mandible. In certain cases these can be disfiguring.
Click here to see a diagrammatic representation of the border irregularities caused by sagittal and horizontal osteotomies of the mandible and how they can be corrected with implants.
This patient had undergone sagittal split osteotomy and sliding genioplasty in the past. Dr. Yaremchuk shortened the vertical height of the chin. He placed mandible and chin implants to widen the lower face and make the inferior border of the mandible even. |
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patient example 8
This patient had had her occlusion corrected with orthodontics. The shape of her lower jaw was changed by shortening the chin and then augmenting the chin and the mandible with implants as shown in the diagram.
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patient example 9
This patient's microgenia was corrected by increasing the vertical height of the chin with a lengthening horizontal osteotomy and augmenting the chin and mandible with implants as shown in the diagram.
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patient example 10
This patient underwent a similar procedure to patient example 9.
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patient example 11
This patient had several rhinoplasties and blepharoplasty in the past.
He underwent revision rhinoplasty to deepen his radix and lower his nostril rims, infraorbital rim and midface augmentation, lengthening of his chin by horizontal osteotomy, and mandibular augmentation.
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patient example 12
This patient underwent horizontal osteotomy of his chin with lengthening, sagittal augmentation of the chin with an implant as well as posterior mandible augmentation.
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patient example 13
This patient with micrognathia underwent chin and mandible augmentation.
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patient example 14
This patient with micrognathia underwent chin and mandible augmentation.
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patient example 15
This patient with micrognathia underwent chin and mandible augmentation.
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