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Technical Strategies – Splitting the Custom Jawline Implant

 

A custom jawline implant has become the premiere method of total jawline augmentation. Being able to control the dimensions of the three corners of the jawline (chin and jaw angles) as well as its connections through the body of the mandible creates the opportunity for a complete lower facial skeletal makeover.

This type of facial implant is very powerful because it covers a broad surface area. This creates a naturally stronger effect than ‘spot’ augmentation alone of just the chin or jaw angles. (or even both) But with larger implants comes the challenge of how to insert it into the subperiosteal jawline pocket.

Just because a custom jawline implant is bigger, the size and location of the incisions toinsert it do not have to be. Like all silicone implants their flexibility permits insertion through still small incisions. But the real issue with their insertion is passing underneath the mental nerve on each side where the subperiosteal tunnel is the narrowest. While this can be accomplished in such implants with smaller jaw angle components, the risk of nerve injury is always present.

I have developed a two-piece approach to placing custom jawline implants that substantially reduces the risk of mental nerve injury. Rather than passing the jaw angle portions of the implant as a single piece in a front to back direction (which also makes for a bigger submental or intraoral incision) the implant is split in the midline and then passed in a back to front direction. This allows the smaller chin segment to pass through the subperiosteal tunnel under the nerve. The implant is then reunited in the midline once positioned. I usually use interlocking midline split design which helps ensure that segments are not rotated once reunited.

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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