Dipa Patel, DDS

I believe that this is in the realm of normal, sorry if that isnt encouraging because I know it is very uncomfortable. Try sleeping on several pillow for comfort. Also I would alternate Tylenol and Motrin as that combination is most effective. 

Lastly, the pictures arent projecting very well, but I would assure that the sinus was not a factor in this, sometimes the involvement of the sinus can make things a bit worse.

I would recommend holding off. Depending on the type of jaw surgery you had, you still may be swollen at this time. At 20 days there still is a bit of residual swelling present. If you are determined to proceed with filler I would urge your practitioner to under, rather than overtreat. 

You want to stick to soft cold foods, nothing hard or crunchy at this point. Anything that you have that is too crunchy will get stuck in the sockets and can impede the healing process. Avoid straws, suction in the mouth, or any aggressive rinsing as this can cause issues with healing as well. Pudding, applesauce, milkshakes are advanced to eggs, fish and pasta type foods over the 3-4 days after surgery. 

I would consider Kybella. It is an injectable material that dissolves fat and is currently FDA approved for under the jawline only. With 2 cycles of treatment I think you would be quite happy with the results you achieve. 

It can be difficult to tell based on an x ray alone whether the implant was installed properly. Certainly x rays can come out angled, and sometimes an implant needs to be angled slightly to obtain primary stability, which is by far the most important thing to an implant being integrated long term. As for the charge of the graft, this is often not covered by insurance. Costs of bone grafts vary significantly based on the type of graft, donor site, how much bone is taken, etc.