Custom jawline implants provide a powerful tool for lower facial change. Covering the entire jawline from angle to angle provides a lot of surface area coverage to create significant augmentation effects.
These powerful implant changes have a double edge sword effect. With the right implant design and dimensions many desired patient jawline effects can be seen. What the right implant design and dimensions are, however, is never exactly clear before surgery in the designing process. There is no formula or design method that is available that can predict what the implant design to final effect result will be. This remains an artistic process that lacks complete clinical predictability.
Having done many custom jawline implant designs there are three components of the process to consider. They are the chin, the jaw angle area and the connecting body portion. I find that the chin and the connecting body portions are usually straightforward and create few design quandries.
Designing the jaw angle areas of the implant, however, is a different story. The 3D effects of its vertical, horizontal and transverse dimensions creates challenging design considerations. Because much of the jaw angle dimensions are off the bone and ‘out into space’ it is hard to precisely predict its effects. How the soft tissue will respond and redrape over expanded hard tissue boundaries is one issue. What aesthetic effect will a larger prominence create at the back of the jaw on both sides is another. The larger the change in the jaw angle area the more unpredictable these effects become.
I have done many custom jawline implants with very satisfying aesthetic outcomes. But I have also seen many other such implants where its effects were unpredicted and had to be revised. In almost every instance it was the jaw angle component that posed the problem. In most instances its appearance not its position on the bone was the issue.
Dr. Barry Eppley
Indianapolis, Indiana