Background: Female jaw augmentation has different dimensions than that of a male jawline augmentation. Women usually desire less vchin augmentation and more vertical rather than widening jaw angle augmentation. The overall jawline implant size is smaller often being less than10 ccs in size. The jawline implant size is often smaller if for no other reason than the female jaw is usually smaller than most mens.
In the small female jaw they’re usually is more of vertical deficiency than that of width. Thus there is a need for some degree of vertical jawline lengthening by lowering the inferior border. Such vertical jaw lengthening can often be from the chin the whole way back to the jaw angles which will lengthen a small face and give it more definition. The placement of such a vertical lengthening jawline implant is best done, even in a female, with the use of an anterior submental skin incision.
Case Study: This female had a history of a prior chin implant augmentation through a small submental skin incision. This was a small chin implant of 4 mm which had a moderate chin augmentation effect but was inadequate for her overall jaw augmentation goals. In her 3D CT scan the chin implant could be seen to have a large amount of bony overgrowth.
Using her 3-D CT scan a custom jawline implant was designed that added vertical length from the chin on back to the jaw angles. The vertical lengthening effect was greatest in the jaw angle area.
In the front view the jawline implant design had a round and non-square shape to it.
Under general anesthesia and through her existing submental scar the existing chin implant was removed. In doing the subperiosteal dissection posteriorly all of the bony overgrowth needed to be removed.
The custom jawline implant was inserted through the submental skin incision and positioned posteriorly using bilateral intraoral vestibular incisions. Screw fixation was done at all three corners. In the chin a requested vertical cleft was made into which the screw was applied.
Three months later the change in her jawline could be appreciated with a fuller lower third of the face and improved jawline definition.
Vertical lengthening of the jawline in its entirety can only be successfully done by a custom jawline implant. There is no effective autologous method to do so unless a bimaxillary procedure is done to elongate the face which is rarely done or indicated. The key to successful placement of a vertical jawline lengthening implant is coming at it from an inferior approach. The subperiosteal dissection needs to be done along the entire inferior border which is hard to do from a completely intraoral approach.
Key Points:
1) Female jaw augmentation has different dimensional considerations than that of a male.
2) The one distinct advantage of a custom jawline implant is in its ability to vertically lengthen the entire jawline.
3) Accurate placementt of vertical lengthening jawline implant is best done using an external submental incision.
Dr. Barry Eppley
World-Renowned Plastic Surgeon