Background: The aesthetics of an appealing lower facial shape from the structure of the lower jaw is certainly influenced by the patient’s gender. While a desire for a well defined jawline is universal there are specific differences between what that constitutes for men vs women. A strong lower jaw in a male tends to be more angular with definitive chin and jaw angle shapes. It may be longer and wider as well. A strong jawline in a female usually has less angularity with softer chin and jaw angle shapes. Overall it may not be as big as most female faces are smaller than men’s.
How to create a stronger jawline in a female depends on an understanding of these differences as well as how to use implants to create it. Like in any patient the first step is with the use of computer imaging to see what type of jawline shape and size the patient wants. Then based on this established target the implants needed to do so can be determined. And the basic implant question whether standard chin and jaw angle implants will work or whether custom implant designs are needed. If this process is not done undesired jawline augmentation results have a high probability of occurring.
Case Study: This female had a prior facial augmentation procedure consisting of standard cheek, chin and jaw angle implants. The result was an undesired masculinization of her face which made her look older as well as elongated her face. Her 3D CT scan showed the existing standard size and location of the implants with significant anterior malposition of the jaw angle implants.
An implant replacement approach was devised using custom jawline and cheek implants to soften her face, shorten the chin and make for a more defined female jawline.
Under general anesthesia the existing chin and jaw angles were removed. The chin bone was vertically shortened 5mms from the submental incision by an inferior border shave. The new jawline implant was then placed.
Her cheek implants were removed and replaced with new’ angel wing’ style cheek implants.
When seen 6 months later the change and improvement in the shape of her face could be appreciated. She was much happier with these implant effects.
Getting a desired facial reshaping effect is far more complex than just pulling some implants off the shelf and sticking them onto the face. You have to first know what the patient’s exact facial reshaping goals are. Surgeons shouldn’t assume that they know what they are. Only a visual discussion using imaging can define those goals. Unfortunately as this case study shows knowing what hasn’t worked helps one determine what will work better.
Key Points:
1) There are significant gender differences in what a good jaw augmentation result is.
2) Standard chin and jaw angle implants may not create a good jaw augmentation result due to malpositoning and/or size and shape issues.
3) A custom jawline implant can change the whole shape of the jawline to a softer more feminine shape.
Dr. Barry Eppley
World-Renowned Plastic Surgeon