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A more defined jaw angle is a not uncommon request of men, particularly younger men. I am seeing more of these patients recently than ever before. This is presumably driven by the desire for increased facial angularity and jaw line definition as seen in many male models. Surprisingly, I have also seen a few women with the same request although the female models that I have seen with this look (surgically created or natural?) look a little cartoonish to me.
Either male or female, the procedure is the same. An intraoral incision is used along the back part of the jaw. The large masseter muscle is lifted up along the entire angle of the jaw. The only ‘difficult’ part of a jaw implant angle procedure, in my opinion, is in the selection of the type of implant material (silicone rubber vs. polyethylene (Porex) and the exact style and size of the implant. There are theoretical differences between silicone vs polyethylene but, in the big picture, I am not sure any real differences exist in terms of postoperative outcome. I think the plastic surgeon should use whichever implant material thay are most comfortable. Whether to drop the existing jawline by an extended implant or simple along the current jawline to be widened is another decision. I found that most of the time an extended implant that lowers the jawline is most useful in those patients who have an ill-defined jawline that is both narrow and obtuse in angularity. Many men will get an extended style of implant, the few women I have done get a little increased width only. Whatever jaw implant is chosen and placed, it is very important to secure it in place with a screw or two. The only complications I have ever seen with jaw angle implants has been implant migration toward the incision. This risk is completely eliminated by secure screw fixation.
After surgery, there is a fair amount of discomfort due to muscle trismus and swelling. Unlike any other facial implant, jaw angle implants produce the greatest amount of discomfort and dysfunction. (difficulty with opening your mouth for a few weeks) However, jaw angle implants produce a nice lower profile change that is second only to what a chin implant can do. Sometimes, for maximum effect, jaw angle implants and chin implants may be done together to accentuate the entire jawline.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian North Medical Center, Avon, Indiana
Indianapolis

The facial features most associated with masculinity is the chin and jawline. A stronger chin and jawline conveys increased masculinity, smaller chins and ill-defined jawlines convey timidity and weakness. While this perceptions may not always be true (and often aren’t), they certainly help create a first impression by their appearance. In today’s plastic surgery, newer generation implants and fillers make this look possible more than ever before.
Chin implants have really evolved over the past decade with many new styles and sizes. The most important change has been that they have been extended in their shape rather than small ‘buttons’. The idea is to have an enhanced chin that flows better into the surrounding jaw. This requires an implant that ‘extends’ back from the chin to create a smooth transition from the augmented chin to the back of the jaw. These newer implants are longer and more tapered at the ends, although they can still be placed through a small incision right under the chin. Because they extend back further they give an enhanced but natural appearance to the chin. This is achieved by filling in the jawline between the chin and the back of the jaw, slightly widening the anterior jawline making the overall look more balanced. In addition to jawline width, chin and jawline height can also be lengthened by having a ‘wrap-around’ implant that extends lower than the existing edge of the bone. Prior to these type of implants, only cutting the bone or bone grafting could have achieved this look. This increases the height of the lower third of the face, a very male-enhancing effect.
New implant options also exist for bolder cheekbones and more square jaw angles. Small cheekbones generally are not as obvious as a smaller chin but the effect on the appearance of the face is just as real. Small cheek bones create a flatter facial appearance or even a longer thin face look. Several styles of cheek implants exist to fill out different areas of the midface, from creating higher cheekbones to improving that sunken cheek look. Cheek implants are placed through an incision in the mouth so there is no scarring. A more square and well-defined jaw angle is a very masculinizing look and can only be created with implants. Jaw angle implants can eitehr widen the back of the jaw, make it more longer and more square, or both. Like cheek implants they are placed inside the mouth so scarring is never any issue.
It would not be uncommon to perform several areas of facial enhancement in the male to get the overall look that they want. Since an appreciation of facial shape and how the different areas can be changed and how they would look from implants mandates that computer-imaging be used. I find it usually takes at least two consultations to thoroughly cover all the options and make sure the patient has complete understanding of the facial look that they desire.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Chin Implants for Facial Enhancement in Indianapolis by Dr. Barry Eppley

In the pursuit of improved facial balance and shape, the chin is one of the most prominent facial features. When combined with the nose, these two protruding structures have great influence on the overall appearance of the face. We usually don’t give the chin much thought, until it is either too weak or too prominent, and then it becomes the defining part of one’s face (in a negative way). When the chin is deficient (weak), the facial profile has a very convex appearance with the appearance of a short neck as well. As long as the chin deficiency is not too great and the overall jaw is not short with a malocclusion (bad bite), when jaw lengthening surgery may be more appropriate, the use of a chin implant is a simple and proven method. In my practice here in Indianapolis, I always discuss with the patient the two methods of chin enhancement; implants vs osteotomy (moving the bone forward). Over 90% of the time, a chin implant is chosen.

While chin implants are available in different materials, I prefer the use of solid silicone (rubber) chin implants, which are still by far the most commonly used. They are soft, flexible, and slide easily into place along the chin bone. The chin implant is inserted through a small incision hidden underneath the chin below the jaw line. This leaves no visible scar. Usually the chin implant is sutured into place, however, I sometimes use a metal screw to secure the implant to the bone. This screw fixation method can eliminate one of the very few complications of chin implants, that of shifting or changing position after surgery causing chin asymmetry. I rarely insert a chin implant through the mouth as it is more painful, has more swelling, and is more easily displaced upward off the chin prominence.While any implant (foreign-body) has some risk of infection, chin implant infections are quite uncommon.

Enhancing the chin with an implant is the most commonly performed facial implant procedure. The goal of a chin implant is to bring the chin forward enough so that it is in balance to the nose and lips. Unlike the old style ‘button’ chin implant, there are many different styles of chin implants today. From curved anatomical styles, to a more box shape, to chin implants with a central dimple, there are many options to custom tailor a chin implant to fit most patient’s faces. The different sizes of chin implants makes it possible to make a subtle or a dramatic facial change, dependent upon the patient’s cosmetic needs.

Chin implants are commonly in conjunction with other facial procedures including rhinoplasty, neck liposuction, and facelifts. In some cases, the use of different implants in the same patient, such as a chin and jaw angle implants in a male, can provide dramatic changes in one’s facial appearance. Chin implants are a powerful procedure, that is simple and usually uncomplicated, to achieve better facial balance.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, IndianaIndianap