There are two powerful jawline techniques for changing the size and shape of the lower third of the face. Orthognathic surgery is well known and has been done for many decades. In the developmentally deficient lower jaw sagittal split osteotomies, particularly if a chin augmentation is combined with it, can produce dramatic changes in the prominence of the jawline and in the shape of the neck. But its use is restricted to patients that have a significant bite deformity which serves as the basis of the set point of the moved jaw.
In the aesthetic patient with a functional occlusion, regardless of their jaw development, orthognathic surgery is not a viable treatment option. A custom jawline implant is not only the only treatment option in he aesthetic patient but an extremely effective one. It usually has an even more powerful effect because its bony surface area coverage allows for a true 3D volumetric jawline change.
When looking at the size of a custom jawline implant, a key question is how it is possible to surgically place it with minimal scarring. The size of the implant and its aesthetic potential is of little value if it can not be safely placed without causing other undue aesthetic problems.
The answer to custom jawline implant placement is the properties of the material. Silicone is the only material from a which a true one-piece custom jawline implant can be made and placed. It is due to the flexible nature of the solid silicone material. While firm it is still flexible but with 100$ elastic recoil…meaning no matter how it is bent or flexed it will retain its performed shape.
It is this flexibility that allows it to be inserted through small incisions of which the anterior one (intraoral mucosal or submental skin) is the key. Its placement is done through a three incisional pocket dissection method, one anterior incision and two posterior paired vestibular mucosal incisions. The complete subperiosteal pocket dissections are done at the chin and jaw angles and then they are connected by a subperiosteal tunnel between them. The flexibility of the implant allows the back ends to be inserted from the chin area and pass back to the jaw angles on each side. This then allows the front end of the implant to be seated. There is definitely an art form in learning how to so this implant placement. But it would never be possible if the implant was not flexible.
Patients often think that a jaw or any facial bone implant needs to feel like bone…it needs to be stiff and rigid to feel right. However this is not accurate or necessary. Like wallpaper on a wall, a flexible custom jawline implant will feel just like bone when placed up against it.
Dr. Barry Eppley
Indianapolis Indiana