Synthetic implants are the only method for increasing the size and prominence of the jaw angles. Placed over the junction of the posterior and inferior mandibular borders, the implant’s design and shape can help make the jaw angle’s definition more pronounced. By so doing, particularly when done on both sides, the width of the back of the jawline is increased creating a stronger and more masculine facial appearance.
Like any implant surgery, proper sizing and placement of the implant is essential for a good outcome. Jaw angle implants are available from only a few manufacturers with limited designs and sizes. Most commonly, the implant is designed close to an L-shape with about 4.5 cms of vertical height and horizontal length to it and no greater than 6 to 8mms in width. At these dimensions, the implant can certainly fit onto most jaws angles without being oversized. If measurements are taken on each patient, there is never a problem with fitting these implant sizes to the jaw, even in women.
My experience has been, however, that even the largest jaw angle implant commercially available (silicone) may be too small for some men. While they do make a difference, particularly when done bilaterally, some of my patients certainly comment thaty they wish they were bigger and provided even more definition. While it is possible to double stack jaw angle implants on top of each other (larger one against the bone and a smaller on top), I advise against this due to a high likelihood of shifting and displacement. (unless one can get double screw fixation on both sides) For this reason, I haved use a SAM (Gore-tex) block and carve out my own implant sizes which can be made bigger. This is more expensive than silicone implants but is more effective when bigger sizes are needed. These Gore-tex blocks are also not as smooth and slippery as silicone and this increased frictional gripping is also helpful when one can not get or does not want to place screws for fixation.
When vertical jaw angle lengthening is needed, the only current option is a Medpor jaw angle implants. Implant sizes go up to 11mms in width and 10mms in vertical lengthening which is more than adequate for most patient’s aesthetic needs. But some patients need more vertical lengthening than 10mms. To achieve greater than that amount, a custom implant design manufactured off of the patient’s 3D CT scan and model is needed.
Better jaw angle implant designs and sizes are needed, particularly in silicone materials. But until these are commerically available, custom designed jaw angle implants need to be used.
Dr. Barry Eppley
Indianapolis, Indiana