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Implant Placement, Bone Screws & More

The number one reason for a revision jaw augmentation surgery regarding cosmetic reasons is dissatisfaction from improper implant placement.  The three main placements can be:

Full Mandibular (combination, wrap around): The entire jaw can be augmented if need be with an implant designed to fit together like a puzzle and secured with titanium screws, sutures or wire.  This is more of a wrap around style, sometimes jointed from 3 separate pieces.

Scar Capsule Formation
As with any foreign body, a scar capsule may form around the implant. Discuss with your doctor his preferred implant material and brand of choice for further information.  This should not effect the cosmetic results of your jaw implants as it can with breast implants.  Jaw implants are hard and will not distort under the contraction of a fibrous membrane.

Sizing
The second reason?  Too big or too small of an implant. In common augmentation cases, 4mm thick implants are used.  It is possible that one may need more and these implants are easily ordered as is, custom-ordered or carved from solid medical grade implant silicone or other type blocks to suit your individual needs.  Also, there may be in-office sizers to determine the augmentation size pre-operatively although do not rely on these as they are often hard to place for a realistic preview.

Saline injections can be used and are a little painful but helpful.  They will not give you a superlative idea of definition, but they can let you know what it looks like to have a strong jaw line before you actually get them.

Commuter Imaging is another source of "try-on."  Please see our computer imaging section for more information.

Implant Fixation
The third reason? Displacement, i.e. "shifting."  The main reason implants shift is because of improper pocket formation.  You do not need fixation with screws to hold your implant in place.  A perfectly sized pocket can be made and hold your implant in place.  

For those of you who insist on fixation, titanium screws may be the answer. These screws can be used to secure most solid silicone and other types of jaw implants into your underlying bone to fixate the implant and prevent it from shifting.  A few patients report occasional cold sensitivity when screws have been utilized.  This is usually remedied by ascertaining that the screws are placed away from any nerve clusters.

Another option is permanent or resorbable suture fixation. The implant can also be fixated with a non-resorbable (permanent) or resorbable suture material onto the periosteum.  The periosteum is thick and is often used in chin implant fixation.  It can successfully  be used with jaw implants as well.