Problems with jaw angle implants

[Deleted member 7747]

It surprises me that it has been that difficult for you to find surgeons who provide jaw angle implants and that the ones who do charge so much money for it. I mean, in terms of complications, wouldn‘t a custom wraparound jaw implant be just as, if not more, risky as angle implants? I suppose that it might be easier to find surgeons who work with wraparound and chin implants.
Btw, I‘m not looking for any more vertical ramus projection, my ramus is already more than long enough, I only want more bigonial width and maybe also a slight gonial outward flare. I read that jaw angle implants that are supposed to increase ramus length are more problematic in terms of masseter muscle reattachment than implants which only provide more horizontal projection.

What bothers me about fillers is
1. they‘re not permanent. Radiesse might last longer than HA-based fillers but it still won‘t last forever
2. the price you pay in the long term vs one-time investment in implants
3. the large amount I‘d need to fix my low bigonial width
4. it might look slightly different every time and seeing results slowly diminish (just like botox that I‘m getting every couple of months) would be underwhelming/disappointing

Haha don't even get me started on the wrap-around implants, it would be easier to tell a surgeon to attach my nipple on my head than it would be to find a surgeon that offers wrap-around. It may be easier for some people, but the type of surgeons I contacted did not offer this.

All mandible implants are inserted inside the mouth through an internal oral insertion. Typically the surgeon has to rearrange the masseter muscle in order to insert the implant, which resides next to the major facial artery, the marginal mandibular nerve. Irritating or damaging this nerve can cause major facial paralysis, which may be permanent. This also typically occurs in people that have strokes, so you may end up looking like a stroke victim, quite literally. This is the risk that pertains to mandible implants, which is why some surgeons refrain from this procedure. (Obviously I'm not saying that this will happen, and I'm sure many patients have had successful mandible implants, I'm only highlighting the risk to make you aware why some surgeons don't offer this procedure in their practice).

I still think implants and fillers have their place in aesthetics. Implants are definitely recommended for any major facial deformities or recession. But if you simply want to make your face more attractive by adding small increments of volume in the form of millimetres, then I would suggest dermal fillers.

Hmm that's fair enough. Each have their advantages and disadvantages though. But:
1. Nothing truly is permanent. Even a facial implants needs to be removed or replaced at some point in a patients life. As we age, bony tissue begins to atrophy, which means that the position of the implant becomes misaligned. Plus some things are inevitable, time-wise. You'll be brushing your teeth and wiping your ass every day, and cutting your hair every four weeks, for the rest of your life. Having a 15 minute procedure, once a year, truly will not be that much of an inconvenience.
2. That's true. But it's 'only' €400ish a year. It's not THAT much, haha. If you make €30,000 a year, it would only equate to 1.5% of your total income being spent on filler, annually.
3. You don't know until you try. Filler is all about manipulating light and shadows, so you may need less than you think. I naturally have a diamond face shape, but 1.5 ML, in total, is enough to increase my bigonial width and make it parallel to my bizygomatic width.
4. True, that is the only downfall. As cosmetic medicine advances, I can only hope that in five to ten years time they develop a longer-lasting dermal filler. One that truly does emulate bone. The industry is changing every day, and is rapidly growing. We can only hope.

Good luck with everything man. I remember being in your situation, trying to decide the surgical and implant route for the jaw, and it was truly fucking distressing. Hopefully you find the result you're looking for, brother! All the best.

 

[Bewusst]

Haha don't even get me started on the wrap-around implants, it would be easier to tell a surgeon to attach my nipple on my head than it would be to find a surgeon that offers wrap-around. It may be easier for some people, but the type of surgeons I contacted did not offer this.

All mandible implants are inserted inside the mouth through an internal oral insertion. Typically the surgeon has to rearrange the masseter muscle in order to insert the implant, which resides next to the major facial artery, the marginal mandibular nerve. Irritating or damaging this nerve can cause major facial paralysis, which may be permanent. This also typically occurs in people that have strokes, so you may end up looking like a stroke victim, quite literally. This is the risk that pertains to mandible implants, which is why some surgeons refrain from this procedure. (Obviously I'm not saying that this will happen, and I'm sure many patients have had successful mandible implants, I'm only highlighting the risk to make you aware why some surgeons don't offer this procedure in their practice).

I still think implants and fillers have their place in aesthetics. Implants are definitely recommended for any major facial deformities or recession. But if you simply want to make your face more attractive by adding small increments of volume in the form of millimetres, then I would suggest dermal fillers.

Hmm that's fair enough. Each have their advantages and disadvantages though. But:
1. Nothing truly is permanent. Even a facial implants needs to be removed or replaced at some point in a patients life. As we age, bony tissue begins to atrophy, which means that the position of the implant becomes misaligned. Plus some things are inevitable, time-wise. You'll be brushing your teeth and wiping your ass every day, and cutting your hair every four weeks, for the rest of your life. Having a 15 minute procedure, once a year, truly will not be that much of an inconvenience.
2. That's true. But it's 'only' €400ish a year. It's not THAT much, haha. If you make €30,000 a year, it would only equate to 1.5% of your total income being spent on filler, annually.
3. You don't know until you try. Filler is all about manipulating light and shadows, so you may need less than you think. I naturally have a diamond face shape, but 1.5 ML, in total, is enough to increase my bigonial width and make it parallel to my bizygomatic width.
4. True, that is the only downfall. As cosmetic medicine advances, I can only hope that in five to ten years time they develop a longer-lasting dermal filler. One that truly does emulate bone. The industry is changing every day, and is rapidly growing. We can only hope.

Good luck with everything man. I remember being in your situation, trying to decide the surgical and implant route for the jaw, and it was truly fucking distressing. Hopefully you find the result you're looking for, brother! All the best.

Few more questions. Do you know how they reattach the masseter muscle? How is it fixed to the bone/implant? How quickly do you notice filler results subside and your jaw „shrink“? Is there a noticeable difference after the 6 month mark compared to post treatment? Also, wouldn’t the added volume from fillers push against/stretch the masseters (similar to implants) and restrict mouth opening range?

I‘ve grown an aversion towards short term procedures. I‘ve been getting a reverse brow lift with botox every few months for over a year and although it looks great a few days post treatment, the results quickly subside until I can‘t stand the look anymore and have to get a new round of injections. For this reason, I’m getting surgery for it soon. I can imagine it would be similar with fillers

 

[Deleted member 7747]

Few more questions. Do you know how they reattach the masseter muscle? How is it fixed to the bone/implant? How quickly do you notice filler results subside and your jaw „shrink“? Is there a noticeable difference after the 6 month mark compared to post treatment? Also, wouldn’t the added volume from fillers push against/stretch the masseters (similar to implants) and restrict mouth opening range?

I‘ve grown an aversion towards short term procedures. I‘ve been getting a reverse brow lift with botox every few months for over a year and although it looks great a few days post treatment, the results quickly subside until I can‘t stand the look anymore and have to get a new round of injections. For this reason, I’m getting surgery for it soon. I can imagine it would be similar with fillers

Hmm I'm not sure the technical surgical method of inserting an implant would be, but I do understand from knowing human anatomy that the implant is inserted laterally to the masseter from an intraoral insertion. With filler, product is injected onto the periosteum (bone) of the angle of the mandible. The product is injected laterally to the masseter, not anteriorly, so it will not have an impact on enunciation or the opening of the mouth.

I do agree, Botox is quite frustrating. There is allegedly a new botulinum toxin product called RT002 that's in the final stages of phase-three clinical research trials that is being tested which claims to last six months or more, instead of three. This will be an ultimate game-changer. Let's hope it gets approved.

But fillers work differently to Botox. There is collagen formation and macrophage stimulation that occurs with dermal fillers, and biostimulators like Radiesse and Ellansé, which means that there will still be some residual projection and volume created even after the product has been metabolised by the body. This new collagen formation can last between one to three years, or more, which means that the area that has been treated never truly goes back to its original form how it was prior to injection, because of this new collagen production. It's yours to keep for several years, even after the filler's microspheres have been absorbed and excreted by the body. That's why you end up needing less product over time, and can go a longer duration in-between injections.

 

[Deleted member 7725]

Hmm I'm not sure the technical surgical method of inserting an implant would be, but I do understand from knowing human anatomy that the implant is inserted laterally to the masseter from an intraoral insertion. With filler, product is injected onto the periosteum (bone) of the angle of the mandible. The product is injected laterally to the masseter, not anteriorly, so it will not have an impact on enunciation or the opening of the mouth.

I do agree, Botox is quite frustrating. There is allegedly a new botulinum toxin product called RT002 that's in the final stages of phase-three clinical research trials that is being tested which claims to last six months or more, instead of three. This will be an ultimate game-changer. Let's hope it gets approved.

But fillers work differently to Botox. There is collagen formation and macrophage stimulation that occurs with dermal fillers, and biostimulators like Radiesse and Ellansé, which means that there will still be some residual projection and volume created even after the product has been metabolised by the body. This new collagen formation can last between one to three years, or more, which means that the area that has been treated never truly goes back to its original form how it was prior to injection, because of this new collagen production. It's yours to keep for several years, even after the filler's microspheres have been absorbed and excreted by the body. That's why you end up needing less product over time, and can go a longer duration in-between injections.

How’d you find a doctor that knows how to fill jawlines? I can’t seem to find one anywhere and I live in a metro area.

 

[FacialAesthetics]

Most jaw implants look terrible because it just widens the mandible when they didn't need it widened. They needed angularity.

 

[Deleted member 7747]

How’d you find a doctor that knows how to fill jawlines? I can’t seem to find one anywhere and I live in a metro area.

The jawline is a pretty common anatomical area to treat with filler. Try to find an injector who's younger, say in their 20's, 30's and early 40's. A lot of the older injector, especially male doctors, can be quite 'text book', and tend to stay away from modern aesthetic trends, such as treating the jawline.

 

[Acromegaly_Chad]

Btw, he likely had a special kind of chin wing (I forgot the name of it) that also allows for more horizontal projection. I remember that Instagram post and he apparently is the only surgeon who performs this kind of chin wing @Juhadi

Its a chin wing either with a so called median split or a segmented chin wing which is basically chin wing and side wing in one procedure. I had exactly that with dr brusco done

 

[Donc0ck]

Its a chin wing either with a so called median split or a segmented chin wing which is basically chin wing and side wing in one procedure. I had exactly that with dr brusco done

Got a pic of only lower third?

 

[Acromegaly_Chad]

Got a pic of only lower third?

Nah dont want to get doxed or him knowing who of his customers browses incel looksmax websites lol

 

[Acromegaly_Chad]

Got a pic of only lower third?

But what I can tell you is that osteotomies are far superior to implants. Most of us are in their early twenties, you'll have to exchange the implant multiple times over your life time, your bone gets eroded, you'll eventually have to make several CT scans then and the older you get the unhealthier anesthesia becomes.

With chin wing and side wing there's literally nothing that can't be done that can be with implants unless the shape of your corpus mandibulae is next level fucked. But even then, you can achieve sharpness with bichectomy, injection lipolysis and fillers. Still better than getting your bone eroded by an implant JFL imagine what those will look like once they hit their 50s.

 

[MentalistKebab]

I do have limited and minimal experience with mandibular angle implants; I'm not sure if it'll help you, though.

It was quite arduous trying to find a plastic surgeon who would offer this particular treatment (UK, Turkey, Australia, Italy). Many of the surgeons I contacted did not offer these type of implants, and would commonly offer an alternative treatment such as dermal fillers or fat grafting. The seldom surgeons who did offer mandibular angle implants would mark-up the price to an astronomical amount. A plastic surgeon I was already familiar with in Turkey, who is typically less costly than the rest of Europe, priced me €7.500 for mandibular angle implants, whereas an implant for the chin was only €3.750. And this surgeon was one of the 'cheaper' options....

I think many surgeons are refraining from this type of treatment, and the ones that do offer implants tend to increase the price quite substantially.

I understand that the marginal mandibular nerve resides next to the gonial angle of the mandible, which makes the process of inserting implants in this area quite high-risk.

I, too, wanted to increase the bigonial width of my jaw, so I removed the submental fat under my chin, and the fat pad that sits along the mandible, and used dermal fillers to increase the projection of my gonial angle. I tend to stray from hyaluronic acid in this area (they can sometimes look a little soft in this region over time), and tend to favour either Radiesse (made of calcium hydroxylapatite, which is the same mineral components found in bone and teeth), or Ellansé (which is made of Polycaprolactone, and is only available in Europe and not yet FDA approved in the USA). Radiesse lasts for up a year and a half, but Ellansé can last up to four years. Both fillers aren't hydrophilic (which means they don't retain water), stimulate the body's collagen production, and have one of the highest G-Prime, cohesivity, and viscosity of all dermal fillers on the market.

I do think that facial implants do have a specific place in cosmetic surgery, but in my opinion, if you solely want a crisper or more chiselled jawline, then perhaps they're not best intended for that, and an alternative cosmetic option should be considered.

I'm still yet to see a mandibular angle implant that I can commend or praise, or that aligns to my aesthetic goals. In my opinion, they look quite soft, rounded and boggy. That is why I would only recommend them to patients who have significant facial or lower-third deformities, because they do look quite natural. And I think that this is the same concept that many plastic surgeons are adopting, too.

But, for me, I prefer a more crisp, cut, chiselled look - which is why I prefer dermal fillers in this area. It's quick, it's painless, and I only have to be treated either once a year, or once every two to three years - depending on the type of filler I chose, and how many times I layer the product. And, it only takes up 15 minutes of my time; which I'm fine with.

Suits me.

Wait, there is a guy that does mandible implants in Turkey ? Can you share his works

 

[Deleted member 7747]

Wait, there is a guy that does mandible implants in Turkey ? Can you share his works

There's a few I've dealt with that offer mandibular implants, but I haven't seen any images of their work.

 

[MentalistKebab]

There's a few I've dealt with that offer mandibular implants, but I haven't seen any images of their work.

I assume you dont know whether they reattach masseters like OP claimed ?

 

[Deleted member 7747]

I assume you dont know whether they reattach masseters like OP claimed ?

I'm not too sure man, but you could always ask them. Many surgeons and clinics in Turkey have a WhatsApp number for international patients - so you can communicate your concerns directly with the surgeon, free of charge.

 

[HighClassMaxing]

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