Jawline contouring, implants, and chin implant post mandibulectomy? (Photo)

Question

I had a fibula flap mandibulectomy to remove a non-cancerous tumor in my lower right mandible. I’m in the process now of getting implants. However, the procedure left my jawline disproportionate, my chin oddly shaped because there isn’t bone there, and my jaw unaligned. Help. The implanted bone has fused and I’m completely healthy. Only hoping to have some semblance of my old face for confidence and hopefully, to alleviate some of the pain the unaligned jaw has left.

Randal Haworth, MD, FACS · Answer

I’m sorry to hear about the challenges you’ve faced, but it’s great to know that you’re healthy and in the process of seeking a resolution. Reconstructive surgery after a fibula flap mandibulectomy is a complex process, and it’s understandable that you are concerned about your facial appearance and alignment.

In your situation, it’s crucial to consult with a team of specialists, including oral and maxillofacial surgeons, plastic surgeons, and possibly prosthodontists or orthodontists. They can evaluate your current condition and discuss potential options to improve your facial symmetry and alignment.

Possible approaches might include additional reconstructive surgery, such as bone grafts or orthognathic surgery, to correct the jaw misalignment and improve the shape of your chin. Prosthetic solutions, such as custom-made implants, might also be considered to restore facial contours and balance.

Best of luck !

Michael P. Morrissette, DDS, FACS · Answer

The best way to achieve symmetry in these cases is to fabricate a custom silicone implant using A CT scan. The non-treated side can be used to make a mirror image. You can proceed with dental implants but for facial symmetry, you will need a custom facial implant.  The surgery is performed in the office with intravenous sedation and the incision is inside the mouth. The recovery is much less than you have already been through.

Mats Hagstrom, MD (license on probation) · Answer

Your situation sounds complex. Your post doesn’t include a question so I’m not sure what you’re trying to seek?
Follow up with the surgeon who did your reconstruction if you have questions or concerns from the outcome.
Best,
Mats Hagstrom, MD

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