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Case Study – Remove and Replace Custom Jawline Implant

 

Background: The jawline for men and women is the key feature of the lower face. While once all focus was on the chin, this perspective is short-sighted today. While many patients will still benefit by chin augmentation alone, a growing number of patients want/need a total jawline approach to achieve their aesthetic facial goals.

Total jawline augmentation consist of changing the chin and the paired jaw angles, the three points of the jaw. There are numerous standard preformed chin and jaw angle implants that are available to do so and the ‘three corner’ jawline technique will work for many patients. But for those patients seeking a linear jawline effect that connects the three corners or who have dimensional needs that may exceed what standard implants can do, a custom jawline implant is the  other option for total jawline augmentation.

Designed and made from the patient’s 3D CT scan a one-piece implant is created from jaw angle to jaw angle. It has the advantage that as a connected piece it is less prone to implant positioning asymmetries than that of three implants. But like all other facial implants, jaw implants included, what the dimensions should be to achieve the patient’s goals is not an exact science.

Case Study: This young male had a prior history of a custom jawline implant. While providing improvement it was not dimensionally adequate and there was jaw angle implant asymmetry. A new 3D CT scan was used to determine the implant’s position and shape.

Having any jaw implants, custom or standard, is an enormous help in knowing how to design a custom jawline implant. Knowing the inadequacies of one implant design provides insight into how to make the next one better. From that information a new custom implant designed. Increased chin projection and vertical lengthening of the jaw angles were additional desk features.

Under general anesthesia and through a three incisional approach, the existing implant was removed and replaced with the newly designed implant. The improvements in the jawline shape were consistent with the implant design improvements.

The effects of a custom jawline implant are based on how it is designed and its position on the bone. Unfortunately there is no exact method to determine before surgery what external facial effect any implant design will create. When the first implant design ‘fails’ it still provides useful information as to how to make the next implant better.

Highlights:

1) A custom jawline implant has the best chance to create a more angular and well-defined jawline….provided the dimensions are correct.

2) Most custom jawline implant designs have to be ‘over exaggerated’ as their effect is blunted by the overling soft tissue cover.

3)  A second custom jawline implant can be done to replace a first one if the dimensions are not adequate.

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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