Evaluation of lower third of the face defieiencies and the appropriate treatment for them can be assessed both from an anatomic unit and dimensional
Step 1 — Evaluate Chin Projection
Assess the pogonion position relative to ideal profile lines (e.g., facial convexity or aesthetic profile line).
Findings
Isolated chin deficiency
- weak chin projection
- normal mandibular width
- normal jawline contour
? Recommended procedure:
Chin implant
Purpose
• improve profile
• increase projection
• improve chin–neck angle
Step 2 — Evaluate Gonial Angle Width
Assess bigonial width vs bizygomatic width.
Findings
Posterior mandibular deficiency
- narrow gonial angles
- weak posterior jawline
- normal chin projection
? Recommended procedure:
Mandibular angle implants
Purpose
• widen posterior jaw
• strengthen masculine frame
Step 3 — Evaluate Mandibular Body Contour
Look for inferior border irregularity or weakness.
Signs include:
- concave mandibular body
- soft jawline definition
- weak transition from angle to chin
Findings
Body deficiency with chin weakness
? Recommended procedure:
Extended chin implant
Purpose
• augment chin projection
• extend along mandibular body
• improve jawline continuity
Step 4 — Evaluate Jawline Continuity
Assess the entire mandibular contour from angle to chin.
Common issues:
- weak angle
- weak mandibular body
- prejowl depression
- asymmetry
Findings
Multi-zone deficiency
? Recommended procedure:
Full wraparound custom jaw implant
Purpose
• augment angle width
• straighten mandibular body
• fill prejowl depression
• integrate chin contour
Decision Tree Diagram
Jawline Evaluation
Is chin projection weak?
/ \
YES NO
Chin Implant Evaluate angle width
Is posterior jaw narrow?
/ \
YES NO
Angle Implants Evaluate body contour
Is body/jawline weak?
/ \
YES NO
Extended Chin Implant Evaluate full jawline
Multi-zone deficiency?
YES
Full Wraparound Custom Jaw Implant
Key Clinical Indicators
|
Finding |
Best Procedure |
|
Chin retrusion only |
Chin implant |
|
Narrow gonial angles |
Angle implants |
|
Chin + body weakness |
Extended chin implant |
|
Weak angle + body + prejowl |
Custom wraparound implant |
|
Jaw asymmetry |
Custom implant |
Additional Factors Influencing Choice
Facial proportions
Relationship of:
- bizygomatic width
- bigonial width
- chin projection
Soft tissue thickness
Thicker tissues may require larger skeletal augmentation.
Asymmetry
Significant asymmetry often favors custom implants.
Patient aesthetic goals
- masculinization
- contour sharpening
- rejuvenation
Practical Surgical Insight
Most surgeons escalate treatment complexity in this order:
Chin implant
?
Angle implants
?
Extended chin implant
?
Custom wraparound jaw implant
Custom implants are typically chosen when multiple mandibular zones require augmentation simultaneously.
Dr. Barry Eppley
Plastic Surgeon