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
Indianapolis, Indiana