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The lower third of the face is dominated by the jawline. The jawline extends from one jaw angle around a convex arch to the other. It is actually the largest surface area of any facial bone prominence. Leading the way is the chin but the jaw angles located at the back play an often equally important aesthetic role. A well-defined chin and jaw angles conveys a stronger facial appearance. Weak chins and jaw angles convey timidity and weakness. While this perception may not always be true (and often isn’t), an ill-defined jawline helps create that impression and often makes the neck appear fuller with an obtuse neck angle. In today’s plastic surgery, newer implant designs and styles opens up the possibilities for a variety of jawline enhancements.

The evolution of chin implants has really evolved over the past decade with many different styles and size options. The most important change has been that they have been extended in their shape rather than just being small central buttons. Having an enhanced chin that flows better into the surrounding jawline is a more anatomic approach for most patients. To have a smooth transition from the chin implant to the side of the jaw, the implant must extend back further to blend into the jawline. These newer implants are longer and more tapered at the ends, although they can still be placed through a small incision right under the chin. Because they extend back further they give an enhanced but natural appearance to the chin. Slightly widening the anterior jawline by filling in this area between the chin and the side of the jaw creates a more balanced look. Chin implants can be placed on the lower edge of the bone to add some vertical length to the chin as well. Square and cleft chin implant styles exist for those that want more chin width or a central chin soft tissue highlight.

Jaw angle implants are one of the newest facial implant options that adds to what the historic chin implant can do for the jawline. A more square and well-defined jaw angle creates a more masculinizing look and can only be created with implants. Jaw angle implants can either widen the back of the jaw, make it more longer and more square, or both. These effects are created by different jaw angle implant style options. They are inserted from inside the mouth so scarring is not a concern.

Combinations of chin and jaw angle implants can create a more complete jawline makeover and are often done together. In some cases, no available off-the-shelf chin or jaw angle implant can create the desired effect due to a patient’s unique anatomy or aesthetic needs. In this situation, a customized ‘wrap-around’ jawline implant can be made from a 3-D CT scan of the patient. These can be made as a single implant or in multiple units that can be inserted in pieces and assembled when next to the bone. This approach is particularly useful when the jawline needs to be vertically lengthened. (implant sitting on the bottom edge of the bone)

Dr. Barry Eppley

Indianapolis, Indiana

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