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Case Study – Custom Jawline Implant Replacement

 

Background: Augmentation of the jawline by today’s standards usually means chin and jaw angle increases. This three-point approach typically uses performed chin and jaw angle implants. With the many different types of facial implants available today, most male and female demands for jaw augmentation can be met.

When using the three implant technique for jaw augmentation, there is a need for accurate placement of each implant. Implant malposition is the number one complication of facial implant surgery. Bilateral facial augmentations, such as the cheek and jaw angles for example, are prone to a unique risk of implant malposition…asymmetry. Even very slight differences in jaw angle implant positions can create visible external asymmetries that can be bothersome to the patient.

If you add up the general risks of implant malposition and size concerns with a single facial implant (around 10%), it is easy to see what the revisional surgery risks are in a three piece jaw augmentation procedure. Since surgical risks are additive for each implant, a total jawline augmentation with standard implants has risks of 30% or greater for issues that may merit revisional surgery. While it is true that some patients are more particular than others about ‘perfection’ or a result that meets their ideal aesthetic goals, my experience has been that most patients seek a result that is more than just close.

malpositioned-jaw-angle-implants-2malpositioned-jaw-angle-implantsCase Study: This 21 year-old female previously had chin and jaw angle implants palced for a complete jaw augmentation effect. While she liked the over all augmentation effect, she as bothered by the jaw angle asymmetry and the lack of a smooth jawline from front to back. A 3D CT scan showed a good chin implant position but obvious jaw angle implant asymmetry with standard widening angle implants. (She also had cheek implants which were asymmetric but that is not relevant to this case study)

custom-jawline-implant-replacement-for-malpositioned-jaw-angle-implants-front-view-dr-barry-eppley-indianapoliscustom-jawline-implant-replacement-for-mapositioned-jaw-angle-implants-side-view-dr-barry-eppley-indianapolisA custom jawline implant was created using the dimensions from her prior implants with some small changes. (9.5mm horizontal chin augmentation, 12mm wide jaw angle) Equally importantly the chin and jaw angles were connected by a smooth implant bar on each side.

custom-jawline-implant-replacement-for-malpositioned-jaw-angle-implants-overlay-dr-barry-eppley-indianapolisThis is a great example of how the custom jawline implant may keep many of the sizes of the standard implants but makes the entire jawline augmentation smooth and connected…like one’s natural jawline. This can be appreciated in the overlay of the existing implants (in green) with the new implant design (in light blue) on the implant planning pictures.

custom-jawline-implant-replacement-dr-barry-eppley-indianapolisUnder general anesthesia her existing submental and intraoral incisions were used to remove her indwelling implants and replace them with the one piece jawline implant.

A three-piece jawline implant augmentation can be prone to less than ideal implant positions and external aesthetic effects. A custom jawline implant can be used for a replacement. The existing implants serve as an invaluable guide in how to design the new one-piece implant.

Highlights:

1) A three-piece jaw augmentation approach using standard implants is prone to implant malpositions.

2) A custom jawline implant can replicate what standard jaw implants can do but in a single implant that is less prone to jaw angle malpositions.

3) A one-piece jaw implant permits a smooth linear connection between the chin and the jaw angles.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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