Background: The features that make for a strong or masculine face are always skeletal in nature. The convex contours of the face, the infraorbital-malar and the jawline, provide the silhouette of a defined and more angular face. The convex contours, the so called trampoline area that lies between these two contour lines, helps add to the appearance of the skeletal contours. But facial concavities alone do not create a well defined face.
Men that seek a more masculine face do so by implants. They may test whether such changes look good by injectable fillers but this does not represent the exact change or offer the permanency that implants do. The key in achieving masculinized facial changes is in the implant designs and dimensions. The debate then always comes down to whether standard or custom facial implants can best achieve it.
While standard chin and jaw angle implants may work in some men for a good jawline appearance, the needed midface/cheek changes is rarely obtainable with a standard implant approach.
Case Study: This young male was interested in achieving a facial masculinization effect through cheek and jawline augmentation. He had a prior history of a chin implant which provided a very modest isolated chin change. Using a 3D CT scan of him custom jawline and cheek implants were designed. The cheek implants had a unique design that provided infraorbital and extended zygomatic arch extensions, a shape not seen in standard cheek implants.
Under general anesthesia the the three male masculinizing implants were placed. Through a submental skin and intraoral posterior vestibular incisions, his existing chin implant was removed and replaced with the custom jawline implant. To enable the jawline implant to be placed as a single piece through the submental incision, grooves were made in the jaw angle portion to allow it to be folded to pass under the mental nerves.
The cheek implants were placed through intraoral vestibular incisions under the lip. Getting them in place required dissection along the infraorbital rim above the nerve as well as back along the zygomatic arch.
Case Highlights:
1) Male masculinization refers to changing the shape of the face to one that has stronger facial features like the chin, jawline and cheeks.
2) Augmenting the skeletal contours of the cheeks and jawline is best done using implants that cover the entire surface of the bones.
3) Custom cheek and jawline implants offer the best approach to producing a facial change that is most harmonious and natural to the skeletal contours that it augments.
Dr. Barry Eppley
Indianapolis, Indiana