Custom jawline implants are one of the most powerful facial enhancement methods as it changes an entire third of the face. Given that it wraps around the entire jawline the length of that distance and its shape along this long curve is unique to each patient. As a result there is no standard wrap around jaw implants available as an off-the-shelf product.
But I did have a recent patient in which this lack of an available standard implant concept was challenged…somewhat.I had a custom jawline patient who when he came in the day before his scheduled surgery was concerned that his jawline implant was too small and would not create enough of an augmentation result. In thinking about how to come a bigger jawline implant within 24 hours an elastomer silicone mold was made of the inner surface of his custom jawline implant model. Once set and pulled from then inside of the jawline implant a model is created of an exact replica of the outer shape of the patient’s jawbone. (which is all that is needed for fitting an implant)
I then went to my collection of custom jawline implant models that I had in stock to see which ones would fit the curve of the jawbone mold impression of the shape of the outer jaw bone. It also had to be overall bigger in dimension than that of his existing custom jawline implant design. This was done by overlaying the implant over the jaw mold.
The key to a good fit is the length of the implant from chin to jaw angle in a front to back direction, particularly at the back end of the jaw angles. You don’t want it to be short nor too long either at the posterior angle border.
I fairly quickly found two implant that fit the mold perfectly…almost like it was made for it. I had these two jawline implants sterilized for surgery in case they were needed. As it turns out the patient’s custom jawline implant produced an excellent intraoperative augmentation so these extra implants were not needed.
But as an exercise to see if it would work it does prove that there may be some merit to a ‘standard’ jawline implant. While there are numerous other dimensions that are important (chin projection and jaw angle width and length) there may be some patients for which an off-the- shelf jawline implant could be an option. The key would be in determining the length of the curve of the jawline at the inferior border. This is usually palpable and measurable on 3D CT scans.
Dr. Barry Eppley
World-Renowned Plastic Surgeon