Custom jawline implants are the definitive method for creating 3D changes to the lower face. In designing a custom jawline implant there are seven specific dimensions that have to be provided to create the desired augmentation effect. These include three for the chin, three for the jaw angles and how one chooses to connect the three corners. The most obvious dimensions to create are in the chin with horizontal (projection), vertical length and transverse width.
Chin width is always the hardest to determine as it is only seen in the frontal view and it is always a choice between a rounder vs a more square chin shape. In the male idea or more square chin shape the landmarks to consider are the width of the mouth or the intercanine distance. But in my vast experience of chin and jawline implant designing the numbers of 32 to 38mms width are the normal range in which few patients ever need widths greater than 38mms and anything less than 32mms would be too narrow.
Another infrequently requested chin feature is to have it create a cleft. This is either to create one that does not exist or to maintain or enhance a cleft that already exists. A cleft is a midline vertical indentation of variable depths located on the lower half of the chin. Such a feature can certainly be put into a chin or jawline implant design. The key in its design is that it must be exaggerated in shape if it has any chance to be seen externally.
In surgery through a submental incision for placement of the implant the chin and its vertical cleft will clearly be seen. The cleft can be made deeper if desired cutting out with a scalpel a deeper wedge. This can serve as a convenient location to place screw fixation if needed based on the amount of implant projection that exists. The cleft allows a less longer self-tapping screw to be placed through it.
When closing the incision the key step is to sew the deeper tissues down into the cleft, helping to ensure it does not fill with scar tissue and obscure the appearance of the cleft.
Dr. Barry Eppley
World-Renowned Plastic Surgeon