Background: The role of the custom jawline implant in facial augmentation is mainly to create dimensional changes to the jawline that standard preformed chin and jaw angle implants can not accomplish. It also creates a unique effect by uniting the chin and jaw angles to create a wrap around effect.
But one of its other uses is to serve as a revisional implant for ‘failed’ chin and jaw angle implant surgeries. While many patients can achieve satisfactory total jawline results using standard chin and jaw angle implants, some patients do not. The most common reason is malposition of the implants particularly those of the jaw angles. Inadequate implant styles and sizes will also magnify the jawline problem.
Case Study: This 32 year-old male had chin and jaw angle implants placed two years previously. He was unsure of his implant types. He felt that the chin had inadequate projection and was pointing downward. The jaw angle implants simply made his face fuller and did not give any jaw angle definition or enlargement. A 3D CT scan showed that the jaw angle implants were positioned far forward of the actual jaw angles and were of the widening style. The chin implant was of a cleft variety that was positioned low off of the chin bone.
A custom jawline implant was designed to create a more effective jawline augmentation effect. The location of the existing chin and jaw angle implants compared to total jawline implant design can be seen in the see-through images.
Under general anesthesia his existing implants were removed. The jaw angles were made of Medpor while the chin implant was of a hand-carved silicone material. The new custom jawline implant can be compared to the implants that were removed. The custom jawline implant was placed through the previous incisions under the chin and inside the mouth.
Custom jawline implants offer a total wraparound jawline effect that can be used as a primary jawline augmentation procedure or to revise prior unsatisfactory standard chin and jaw angle implant results. Replacing existing implants is more challenging than a primary procedure due to the existing capsule (scar) around the inswelling implants. It must be either removed (on the bone) or released. (on the overlying soft tissue)
Highlights:
1) A custom jawline implant can be a good salvage procedure for unsatisfactory results from the implantation of three standard chin and jaw angle implants.
2) The 3D design process uses the location of the current indwelling implants to guide the designing of the dimensions of the new custom implant.
3) As a single piece implant, a custom jawline implant better assures accurate placement on the bone.
Dr. Barry Eppley
Indianapolis, Indiana