JAW ANGLE IMPLANTS | Why doesn't anyone talk about them?
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- Опубликовано: 6 сен 2023
- In this video, Dr. Zelken explores the nuances, challenges, risks, and benefits of jaw angle implants. The mandibular angle, also known as the JAW angle or GONIAL angle is both a measurement (i.e., 140 degrees) AND an anatomic landmark. Its prominence can be attractive, and may be enhanced with jaw angle implant placement. But because the operation is nuanced, challenging, and at higher risk for complications- jaw angle implants are relatively infrequently used. And perhaps because of this, fewer surgeons are trained to place jaw angle implants, and so there are fewer surgeons available to discuss this important procedure to the masses. Dr. Zelken responds to one viewer's request for additional knowledge on JAW ANGLE IMPLANTS in this show and tell session. If you are interested in jawline enhancement with implants, liposuction, facelift, or fillers, call (949) 432-4730 and make an appointment to see Dr. Zelken.
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the real qustion is why there are not more surgeons that talk about custom jaw implants?
More doctors need to talk about this, pro and cons about jaw implants surgery
Very informative.
Are there before and after pictures?
Have you done many of these implant surgeries? I cant find any before and after pics other than one female on your website. I had a chin implant 7 years ago and want to replace it with a full jaw implant.
Thank you so much for talking about this could you do a more detailed video for patients wanting to know if they should get mandibular implants, chin implants or both?
Thank you for posting this.
My pleasure. Its easy to make videos about my passion projects.
Now I wish that I still lived in Newport Beach, cuz I'd pay you a visit in a heartbeat! I have been curious about this exact implant for a while.
We do offer virtual consultations and many of our patients are from out of state.
@@jonathanzelkenmd Ahhhh, I hadn't thought of that. Nonetheless, I have some other procedures that are higher priority than jaw augmentation; so it will be a long time before I could even consider your work. I will remember you, though!
i want a cheek bone just like diamond face shape people have ..is it possible to get that
What is the estimated cost of this procedure? I don't see it listed on your website. Thanks!
Is there a lot of downtime and is the swelling a factor.
Wow thanks for covering this so quick! Did have another question however. With the Stryker implant specifically, you mentioned it cups the gonial angle (which I assume means it slides underneath and around the back of the bone as well), but how would this impact the masseter muscle and where it attaches to the bone? Doesn't the masseter muscle insert/attach on top of the lateral or outside of the mandible? I would think this would tear the masseter or make it impossible for the implant to cup around the bone, as apposed to the implanttech where you mentioned it sorta sits on the bone. So how does an implant like this work when dealing with the masseter? Also is this a procedure you do often and have experience with?
Thanks again for the video and featuring me haha.
The masseter doesn’t really connect to the bone directly. It becomes ligamentous and extends to the backside like a sling. The entire implant is placed underneath that sling without disrupting it. I have experience with this procedure and would like to perform jaw implant surgery more often.
very good work ! do you do any treatments in england uk ? thank you
I do not, sorry. Someday.
@@jonathanzelkenmd ever in Europe ?
Finally!
What do you think about custom implants? Are they worth the extra cost? I am afraid if I go with off the shelf implants, they won't fit well
It truly depends on your anatomy and goals. Remember: off the shelf implants can be customized with a scalpel to some degree
hello doctor, Placing implants in the angle and jaw line will pull the soft tissues and have a lifting effect on the jowls and turkey neck? I have a high, short and stiff mandible.
It is certainly possible but you would have to be seen in person to better assess your question and set expectations
What is the probability of silicone jaw implants moving position over time? I'm a bit concerned about having them screwed in case I don't like them but I also don't know how reliable silicone is. Thanks
Unlikely to move over time. Silicone can easily pull free from a screw but it holds things in place while scar tissue secures the device in position.
Can you do bone (rib) instead of artificial elements?
Yes, it’s possible but would take a much larger incision to shape and position the graft, and would not reliably take. Resorption would be unacceptable and unpredictable. Not to mention the donor site…
Dr. Zelken, which jaw angle implants do you use the most, and from which company? And do you always use screw fixation, even with MEDPOR? Thanks for this much-needed video!
I use Implantech silicone implants most often and rely on screw fixation most of the time. Especially with Medpor. My pleasure
@@jonathanzelkenmd Thanks!
@@jonathanzelkenmd The implant you're handling in the video--is it the RZ Mandibular Angle Implant? I'm planning my own jaw implant procedure, and am researching different implant shapes and styles. Thanks!
Could this be used to fix jaw asymmetry, for example if one side is bigger than the other? If so what are the best options
Yes to a certain extent- it depends on your bite (occlusion) and other features as well.
What are the ramus lengthening limitations with porous polyethylene implant? Is 20 - 25 mm achievable?
If placed properly that would extend the pterygomasseteric sling considerably and may be too much. Of course you would need to be examined first.
I have a short ramus(not visible tbh)but a relatively long and sharp jawline but i feel like the chin is bit recessed Can jaw angle implants help aslo ig theres a need of chin implants alongside it to match the ratio and facial symmetry
You would certainly need to be examined to make this determination
Dr. Zelken,
Are polyethylene jaw implants capable of being removed after a certain timeframe if the final result isn’t satisfactory once healing is complete? If so, is a polyethylene jaw implant difficult to remove after a potential malposition?
I’m a little confused as to the “absorption” part… Does the implant itself essentially become part of the actual jaw bone over time making it difficult for removal? What does the implant absorb?
Very interesting video
Thank you!
Thank you. Its not resorption so much as remodeling. And PEEK implants can certainly be removed. The risk of implant malposition is lower with custom devices that “key” in to position.
you have any before/afters? also what is the healing time?
Hi there, we just posted one on our Instagram page @jonathanzelkenmd
Thank you for the information. I have a question please about custom made implants.
Once the implant is in and everything is set and done, how long does it last ? How many months or years ?
I have patients who have facial implants that were placed 40-50 years ago.
@@jonathanzelkenmdhow much does the surgery cost?
@@jonathanzelkenmd would it be possible to reduce an implant after 20 yrs ? ...like bone shave it / grind it into shape ?.... if too big
do you know of any ways to fix masseter muscle disinsertion from jaw implants?
I am sorry you re dealing with this. I have not treated this complication before. If pressed, I would consider accessing the masseter through a deep plane facelift approach and repairing the dehiscence under direct visualization. Or you could remove the implant and let the tissue contract.
What do you think about bone resorption caused by silicone implants?
I think it happens but is not as big a deal as you might think. Stay tuned for a video on the topic.
Is there a way to make the gonian outward?
Absolutely
Can genioplasty or Orthognathic surgery achieve this wider jaw angle or only with implants ?
Implants
What can one do for hypertrophied parotids due to bulimia?
Neurotoxins like Botox may be a starting point
If someone does it late 20s how the aging effect will be, do they cause harmony issues with aging?
Probably not as it is simply reshaping the jawline for the better.
What if someone has a sort of square looking face and wants a little more V-shape look. How much would that cost?
I second that!
Can this be combined with a deep plane necklift procedure or would it not be recommended to do both at once?
Depends on your physical examination but its possible
@@jonathanzelkenmd Thank you!
Dr. are jaw implants an option for me - a sixty year old woman with minor jowling who is losing bone in her jaw in leiu of a facelift? I'm also have teeth bone issues - thanks for your input
You would need to seen. For the dental issues - it may impact the maxilla and mandible relationship but assuming not, you might not need jaw implants given mild jowling and the prospect of deep fat transfer.
I had jaw angle implants 2 years ago but I don't like them. Is it possible to remove them? They are titanium material implants
Yes these can be removed and you are not alone
😊hi from Brazil viewer
Hello
Have you ever done a Jaw implant? I had cancer five years ago that left me without a lower jaw. I am cancer free but at what cost. Talk about quality of life.
Yes but it sounds like you are looking at a total mandibular reconstruction. I am sorry for your loss and glad you are cancer free, at the very least. Let me know if there’s anything I can do to help.
Can they be removed?
Yes absolutely
Maybe cause is very expensive i read is like $10-15k
Correct
Good to know. Some day, both my daughter and I will schedule a consultation (maybe when we win the lottery 😬). Chins and jaws are almost nonexistent in our DNA. 😒
Sounds extremely expensive