Total joint replacement via pre-auricular approach with no submandibular incision. (a) The pre-auricular incision with anterior extension is marked out prior to preparation and draping and infiltration of local anaesthetic. (b) Dissection through to TMJ as per normal pre-auricular approach. (c) A transbuccal approach is established with a trochar and holes drilled using a drill guide. (d) Fixation of the plate with screws placed through the transbuccal cannula. (e) Visualisation of the prosthesis being fixated with the use of an angled 4 mm endoscope placed through the pre-auricular incision. (f) Closure of the pre-auricular and transbuccal incisions.