A custom jawline implant after vertical chin lengthening is a very logical and commonly paired sequence when the goal is a stronger, longer, and more continuous lower facial contour.
Here’s how these procedures can be done either staged or together. In the staged approach
1. Vertical Chin Lengthening Comes First
Vertical chin lengthening by an opening wedge bony genbioplasty with interpositional bone graft) establishes:
- Lower facial height
- Chin projection and vertical balance
- Proper soft-tissue stretch and drape
This step is critical because it changes the foundation of the lower face. Any jawline implant designed before this would be inaccurate once the chin position is altered.
2. Why a Custom Jawline Implant Is Ideal Afterward
After the chin has been lengthened:
Advantages of a custom implant:
- Designed from a post-genioplasty CT scan
- Seamlessly blends into the newly lengthened chin
- Restores proportional jaw width and angle
- Avoids step-offs or contour mismatches
- Allows asymmetric correction if needed
Stock implants rarely match the new anatomy after vertical lengthening.
3. Implant Design Considerations
A custom jawline implant can be designed to:
- Wrap from angle ? body ? parasymphysis
- Feather smoothly into the chin segment
- Enhance:
- Jaw width
- Jaw angle definition
- Masculine or feminine contouring (as desired)
The implant does not replace the chin bone movement—it complements it.
4. Stability & Longevity
- Custom implants are typically solid silicone.
- Fixed with screws
- Do not resorb
- Results are permanent
Soft tissue settles over ~3–6 months.
5. Common Patient Goals This Combo Addresses
- Weak or narrow jawline after chin lengthening
- “Hanging” or vertically long chin without lateral support
- Need for stronger mandibular angles
- Desire for a continuous, sculpted lower border
Bottom Line
Vertical chin lengthening establishes facial height; the custom jawline implant completes the contour.
When done in the correct sequence, the result looks skeletal—not “implanted.”
Case Study
This male had a prior vertical chin lengthening by osteotomy off an indeterminate amount. He was not satisfied with the amount of lengthening as he received injectable fillers (Radiesse) for additional chin augmentation afterwards. He now sought additional chin lengthening and an overall total jaw augmentation effect behind it. A 3D CT scan showed a lot of filler over and around the chin.
A
custom jawline implant was designed that added 6mms to the chin’s length and 3mms more to the projection. The rest of the jawline was augmented by slight vertical lengthening and 8mms of jaw angle width. The total implant volume was 15.5ccs.
Through a submental incision the custom jawline implant was inserted, positioned and secured with multiple screws to the bone.
Discussion
One-Stage vs Two-Stage Approach
Vertical chin lengthening and custom jawline implant augmentation can be done either together (one stage) and as a two stage approach. In this case the latter was done although it was inadvertent and not initially planned. In many cases this is how it occurs as the initial vertical chin lengthening is usually thought to be a sufficient approach and then, looking at this result, the patient decides to go for a more complete jaw augmentation effect later.
In select cases a combined or one stage approach can be done. When done together the amount of vertical chin lengthening is simulated on the skeletal model and then the jawline implant built around the bony change. It is a technically more challenging surgery to put the two together but it can be effectively done.
The choice between the two approach depends on how much vertical chin lengthening is needed. If the amount is less than 8 to 10mms the bony genioplasty and custom implant can be effectively combined. But when the chin lengthening is 10mms or.greater it is usually best to stage them as fitting the jawline implant around such an elongated chin can be technically challenging..
Barry Eppley, MD, DMD
World-Renowned Plastic Surgeon