Background: Chin implants have been and still are the most common form of aesthetic facial implant augmentation. Because of its placement on the most projecting part of the lower face, which creates a distinct transition from the neck below it, it has been stated that is a facial procedure that has the highest aesthetic value. (benefit vs effort required to do it) If that is an accurate statement then the total jawline implant has an almost similar aesthetic value as it augments the entire lower third of the face.
Many patients start the jaw augmentation journey with a chin implant. Not only is the chin implant more well known and is less invasive to place but its anterior projecting point is the most obvious evidence of a weak jaw. If the chin implant produces a satisfactory result, many patients may never progress beyond that lower facial aesthetic procedure.
But for others, even if the amount of chin augmentation is adequate, it creates the realization that the rest of the lower jaw would benefit by augmentation as well. The indwelling chin implant provides valuable information about the design of the front part of the custom jawline implant design. The back two-thirds of the jawline, however, has no such guidance and those dimensions must come from preoperative imaging of the patient and implant design experience.
Case Study: This male had a previous chin implant of the Type 1 square chin style of 8mm size. While it had a positive effect on chin projection he subsequently desired a more complete jaw augmentation effect.
Using a 3D CT scan a custom jawline implant was designed that added some additional projection to the chin as well as significant jaw angle increases connected to the chin in a linear fashion. (indwelling chin implant in green with the custom jawline implant design overlaid in teal color)
It is easy to see in the top view that in many cases a standard square chin implant doesn’t produce as much as a shape change of the front end of the chin as one would think/desire. It takes a more exaggerated shape change that is actually less wide to do so.
Under general anesthesia and through the typical three incision approach his chin implant was removed and replaced with the custom jawline implant.
When seen two years later he showed a well healed result with significant improvement to the lower third of his face as seen in the side view.
When viewed from the front and oblique the jawline changes were still very impressive.
One interesting observation to make in his before and afters, because of his slight natural chin cleft notice that it has become rotated upward as the chin has had further advancement. And has also become a bit more apparent.
Key Points:
1) A previous chin implant patient is a common history of the contemporary custom jawline implant patient.
2) The existing chin implant provides valuable information to the front end of the custom jawline implant design.
3) In the thick tissue patient the effects of a jawline implant can be seen but sharp definition is rarely possible.
Dr. Barry Eppley
World-Renowned Plastic Surgeon