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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

Mandibular Angle (Jaw) Implants for Facial Enhancement in Indianapolis by Dr. Barry Eppley

For those male patients who desire a more square and angular facial appearance, the mandibular angle or jaw angle implant has become a popular facial implant option. By squaring off and extending the junction of the back and lower borders of the mandible (jaw), the appearance of the jaw becomes wider and more square. This type of look is often desired by younger males, particularly those interested in or already in the modeling field. It is also a very helpful procedure for those patients, male or female, with weaker jaw appearances or jaw asymmetry. I have placed as many mandibular angle implants for jaw asymmetries (one jaw side is very different than the other) as I have for bilateral (both sides) cosmetic enhancements.

In my practice here in Indianapolis, I discuss mandibular angle enhancement through the use of these implants. There are no practical bone-moving procedures for cosmetic enhancement of the mandibular angle, so implants are always used.While mandibular angle implants are available in different materials, I prefer the use of solid silicone (rubber) cheek implants, which are by far the most commonly used. They are soft, flexible, and slide easily into place along the side of the lower jaw. A mandibular angle implant is inserted through an incision in the mouth along the bone in the back part of the jaw. This leaves no visible scar. While it can be inserted through a skin incision in the neck, I have never done so. The mandibular angle implant is slide along the side of the back part of the lower jaw into its position over the edge of the bone. Usually a mandibular angle implant is held in place simply by the pocket into which it is placed. Occasionally, I will use a metal screw to secure the implant to the bone. This screw fixation method can eliminate one of the very few complications of mandibular angle implants, that of shifting position after surgery causing jaw asymmetry and loss of the desired .While any implant (foreign-body) has some risk of infection, mandibular angle implant infections are quite uncommon.

Enhancing the jaw angle with an implant is the least performed facial implant procedure, compared to cheek and chin implants. The goal of a mandibular angle implant is to produce a fullness to the back part of the lower jaw, resulting in a more square facial appearance. There are only a few variations in the styles of mandibular angle implants. The most basic differences in mandibular angle implants is in the amount of extension that can occur from the edges of the bone, both in the back edge as well as the lower edge. Also, different width thicknesses are available, dependent upon how much increase in width of the jaw angle is desired.

Mandibular angle implants are usually done alone but I have also performed them in conjunction with chin and cheek implants. The most powerful way to masculinize a male’s face is the combination of manidbular angle, chin, and cheek implants all done at the same time.

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