A well-defined jawline is a desired aesthetic feature of a male face. A strong lower skeletal profile not only provides a well balanced facial profile but also portrays an image of strength and virility. A strong jawline is created by the horizontal portion of the mandible (lower jaw) and composed of threee main components, the chin and a paired set of jaw angles. Because they come from the same bone and embryologic branchial arch origin, it is not surprising that there is a developmental relationship between them. A stronger chin will usually have better defined and lower positioned jaw angles, a weak chin usually has smaller and more highly positioned jaw angles.
The surgical creation of an improved jawline usually includes chin and jaw angle implants. In a minority of cases, jaw angle implants alone are all that is needed. Isolated jaw angle implant surgery usually occurs when a chin implant was initially done and, although there was anterior jawline improvement, the realization is that jaw angle augmentation is needed as well for a more complete jawline enhancement.
While chin implants come in a variety of styles and sizes, the selection of jaw angle implants is much more limited. With only a few manufacturers, jaw angle implants are available in just two basic styles and a handful of sizes. While this limited selection of implants can actually work for most patient’s jaw angle augmentation needs, it is important to match the right style of jaw angle implant with the patient’s anatomy and their aesthetic desires.
One style of jaw angle implant, and the first that was ever introduced over 15 years ago, is the lateral augmentation design. This implant will make the jaw angle wider, a horizontal increase only. It takes the existing skeletal jaw angle outline and merely adds to it. For the patient who is happy with the position of their jaw angles and wants them to be more prominent or fuller, the lateral augmentation style is ideal. It is the ‘easiest’ jaw angle implant to surgically place as it does not require release of the periosteum from the inferior border of the mandible.
While the lateral augmentation style has been around for a long time, it is actually the least useful as what most patients need (want) is not a width increase only. When the jaw angles are weak they are often highly positioned as well with an obtuse angle shape to them. This type of aesthetic jaw angle deficiency needs a vertical elongation and not just width increase alone. In essence, a new jaw angle needs to be created that is partially below the existing one. This style of jaw angle implant is an inferolateral style that changes the jaw angle to a lower and more acute one. This is the ‘hardest’ type of jaw angle implant to surgically place because the tissues along inferior and posterior portion of the jaw angle must be released. The jaw angle implant must then be properly inserted, without an exact bony guide to the best position, and then secured there by screw fixation.
Jaw angle augmentation today requires an understanding of the patient’s bony anatomy and the style of implant that is best suited to make the desired changes. The inferolateral jaw angle implant is what most male patients need for recreating a lower and more prominent jaw angle that creates a stronger and more horizontal jawline.
Dr. Barry Eppley
Indianapolis, Indiana