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Case Study – Four-Piece Total Jawline Augmentation

 

Background: The desire for a more pronounced and visible lower jawline exists in both men and women. The surgical methods to do so are more commonly requested by men particularly when it comes to a substantially larger jawline change. Making a jawline more evident focuses on increasing the size and shape at its ‘corners’, that of the projecting chin and the back ends at the bilateral angles.

When creating a total jawline augmentation effect, there are two basic approaches.  The historic and still most commonly used method is a three implant approach of independently placed chin and jaw angle implants. In some cases the chin implant may be substituted with a siding genioplasty. The newer method of jawline augmentation is the fabrication and placement of a one-piece custom made jaw implant that wrap around the chin from angle to angle. It is the preferred method of total jawline augmentation given the preoperative designing of the implant and its smooth one-piece construct. But cost considerations may lead some patients to still undergo the classic three implant method.

Chin and jaw angle implants exist in standard styles and sizes. While for some patients these historic standard chin and jaw angle implant styles will effectively work, newer implants styles offer improved total jawline augmentation results for many patients. Newer vertical lengthening jaw angle implants have allowed for increased visible angularity of the back part of the jaw. When vertical elongation of the chin is needed either newer vertical lengthening chin implants can be used or the historic approach of an opening sliding genioplasty. When significant vertical and horizontal chin augmentation is needed, chin implants and a sliding genioplasty can be combined.

Case Study: This 25 year male wanted a total jawline change. Not only was his lower jaw horizontally short but it was vertically deficient as well. This was evident in the short chin and large overbite which are directly related. When he opened his mouth slightly the improvement in his chin and jaw height could be seen confirming the needed vertical dimension of his chin and jawline.

Chin and Jaw Angle Jawline Augmentation result side viewChin and Jaw Angle Jawline Augmentation result oblique viewUnder general anesthesia, he had an opening sliding genioplasty (7ms done and 7mms forward) with a chin implant overly (5mm horizontal augmentation) done through an intraoral approach. Through posterior intraoral incisions jaw angle implants that added 7mm vertical length and 5mm width were placed.

At one year after surgery the improvement in his jawline could be appreciated. Ideally longer vertical lengthening jaw angle implants would have improved his result and are being considered. The sliding genioplasty and chin implant overlay produced a satisfactory improvement to the front part of his jawline

Total jawline augmentation can be effectively done using a non-custom implant approach. It can require the thoughtful application of newer chin and jaw angle implant styles and the selective use of sliding genioplasty techniques.

Highlights:

  1. Total jawline enhancement consists of front (chin) and back (jaw angle) augmentation.
  2. Preformed chin and jaw angle implants is the historic and standard approach to total jawline enhancement.

3. Vertical chin augmentation in total jawline enhancement can be done by a combined sliding genioplasty with a chin implant overlay.

Dr. Barry Eppley

Indianapolis, Indiana

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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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