Jonathan Koster has one more reason to smile.

The young man who became a medical pioneer when he received a custom-designed jaw implant recently underwent a follow-up operation to augment his chin.

“It’s wonderful,” said his mother, Deb Koster. “He just looks so much better. And his jaw just works so much better. And eating is so much easier.”

Asked if he was glad he underwent the operations, Jonathan readily replied, “Yes.”

Jonathan, a 22-year-old from West Michigan, underwent the rare surgery on his jaw on May 27, 2016, at Spectrum Health Helen DeVos Children’s Hospital. He received one of the first implants ever designed for someone who was born without a jawbone.

It looks great. You’ve got a really nice jawline now.

Dr. John Polley
Pediatric craniofacial plastic surgeon

His pediatric craniofacial plastic surgeons, John Polley, MD, and John Girotto, MD, implanted the titanium-and-silicone jawbone on the right side of Jonathan’s face. The implant, custom designed by TMJ Concepts, brought his facial features into symmetrical alignment for the first time in his life.

On Nov. 8, Dr. Polley operated again. He brought the chin bone forward and fixed it in place with plates and screws.

The surgeries corrected a birth defect called hemifacial microsomia, a condition in which the lower half of one side of the face is underdeveloped.

In mid-January, Jonathan returned to Dr. Polley’s office for a follow-up visit.

Dr. Polley held Jonathan’s chin, asked him to open and close his mouth and give a big smile.

“Excellent,” he said. “It looks great. You’ve got a really nice jawline now.”

‘A Grand Rapids legend’

The changes to Jonathan’s face have drawn a lot of attention―from friends, family and church members.

“He’s a legend now,” Dr. Polley said. “A Grand Rapids legend.”

Jonathan smiled and shook his head. He tends to take all the attention in stride.

“Everyone makes such a big deal about the difference, and he’s like, ‘Oh, yeah. That’s the way it is,’” Deb said. “And then he drops it.”

With his new jaw and his teeth in alignment, Jonathan said he can chew food more easily and eat a wider range of foods.

“I had steak yesterday,” he said. That is one of the many foods he avoided in the past.

Recovering from the jaw implant surgery wasn’t easy, he said. He lived for two weeks with his jaw wired shut, living on milkshakes.

“I slept every chance I got,” he said.

But he has endured nearly 30 operations―including surgery to repair his cleft palate, to create an ear, and to put a shunt in his brain. He knows how to cope with the tough days and look ahead to better ones.

“He just took it on like a trouper,” said his dad, Mike Koster.

In general, Jonathan doesn’t dwell on the results of his plastic surgery―he’s too busy with other activities.

He sings in the church choir, plays the piano and organ, attends school at the Community-Based Instruction Program at the Ottawa Area Center. He volunteers every week at Sunset Manor, leading the residents in singing hymns.

And he has been writing a story based on his life―now 100 pages long.

“I include some of my real life, but some of it is made up,” he said. “I kind of go from real life to pretend and back to real life.”

For Jonathan’s parents, seeing such a big change in their son’s face―though exciting―involved a bit of adjustment. It took a little time to get used to his new look.

“Now, it’s like this is just the new Jonathan,” Deb said. “I look at his old pictures and I’m like, ‘Oh, my, what a difference.’ I’m pretty thrilled with it.

“And I think he feels better now that (his face) is straighter.”