Can a Total Jaw Augmentation and Facelift Be Combined?

In older men with significant neck sagging and a weak jawline, a not uncommon question arises: should a custom jawline implant be combined with a full lower facelift for the best aesthetic result? This presents a unique challenge, as jaw augmentation and neck lifting are closely connected—both anatomically and aesthetically.

Understanding the Relationship Between Jaw Augmentation and Necklift

In patients with only mild to moderate jowling and neck laxity, a custom jawline implant alone can often create a satisfactory improvement. However, in cases of more advanced neck sagging, the effects of a jawline implant by itself would be insufficient. The posterior two-thirds of the implant would be largely obscured, with only the chin portion visibly contributing to the result. Therefore, a necklift (full lower facelift) is absolutely necessary.

Point 1: With significanr neck sagging can undergo a necklift without jaw augmentation—but you should not have a jaw augmentation without a necklift.

Combining the Procedures

While a custom jawline implant and a necklift can technically be performed together, recovery is more demanding, primarily due to swelling. Postoperative swelling from the jawline implant can potentially compromise the results of the necklift.

The open exposure provided by a necklift—particularly behind the jaw angle and near the ear—can assist in placing the jaw angle portion of the implant. However, this is more technically challenging in men due to their thicker soft tissue and larger masseter muscles.

Point 2: A necklift and custom jawline implant can be combined—but should they be?

Recommended Staging Strategy

Ideally, the procedures should be performed in stages:

1. Necklift first, to correct neck sagging and redefine the existing jawline contour.

2. Custom jawline implant secondarily, to enhance bone structure once soft tissues have settled.

This sequencing maximizes both aesthetic effect and surgical precision.

An alternative and more traditional strategy is to combine a necklift with chin augmentation rather than full jawline augmentation. Chin implants enhance anterior jaw projection without negatively impacting the necklift result—often improving it. The submental incision made during the necklift conveniently allows for placement of an extended chin implant. If a more comprehensive jawline enhancement is desired later, the prior chin augmentation helps by expanding the soft tissues, facilitating easier implant placement.

Point 3: A combined necklift and chin augmentation offers structural enhancement with an easier recovery and can serve as a foundation for future full jaw augmentation if desired.

Summary of Surgical Options