Chin augmentation is the single most important lower-face procedure in FMS. (A prominent chin is a wholly distinct male feature) Chin augmentation is often perceived only in the profile, ignoring the appearance from the front view. So it is important to consider the appearance of the chin from the front view, assessing tired chin width and squareness as well. An augmented chin that appears more masculine often has a squarer shape to it.
Chin augmentation is usually done by an implant which has the aesthetic advantages of creating increased horizontal projection and width/squareness as well. There are multiple materials for which chin implants are made but solid silicone has the greatest number of styles and sizes and is the easiest to surgically place. (and remove/modify if desired) Chin implants can be introduced through an intraoral or submental skin incision. The sumbmental approach is associated with a lower risk of infection and implant malpositioning.
The cousin to the chin implant is the sliding genioplasty. It has the aesthetic advantage of providing horizontal as well as a vertical projection increase if desired. (so called 45 degree chin augmentation effect) It is often preferred by patients who need larger amounts of chin projection and/or are opposed to having an implant material in their face. The one aesthetic disadvantage to the sliding genioplasty is that is can not make the chin wider or more square. (and in significant amounts in horizontal projection may make it look more narrow) This disadvantage can be overcome by using a chin implant overlay placed on the front edge of the sliding genioplasty to create this missing dimensional change.
Jaw Angle Implants
Besides the chin the other key feature of the male lower face is the jawline. Patients often refer to wanting their jawline enhanced and the surgeon immediately assumes this will be solved by a chin augmentation. What the patient is actually referring to with the word ‘jawline’ is the jaw angle area or a combination of both the chin and jaw angles. This means the entire jawline from the chin to the jaw angles. Having more defined jaw angles together with a prominent chin creates a lower third of the face that defines masculinity.
The traditional approach to achieving this total jawline effect is with standard chin and jaw angles implants. Jaw angle implants are placed through intraoral incisions underneath the masseter muscle. They are either placed directly over the perimeter of the bony jaw angles (widening jaw angle implants) or a portion of the implant lies behind the existing bony jaw angle border. (vertical lengthening jaw angle implants)
Total Jawline Augmentation
While standard chin and jaw angle implants can work well for many jawline augmentations patients, they lack a linear connection between the three corners of the jaw augmentations. (chin and jaw angles) To overcome this potential aesthetic deficiency and create the most profound lower jaw augmentation effect is the custom jawline implant, also known as a jaw wraparound implant.
In a circumferential manner along the entire lower border of the lower jaw an implant can be designed to change its entire shape. Both size and angularity can be created in a 3D fashion. Placed through a three incision technique (submental skin with paired intraoral incisions) the one-piece implant can be inserted and secured.
Dr. Barry Eppley