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Background: Enhancement of the prominence of the jaw angles is today sought by both men and women. For men a more defined jaw angle often means increased width of a bony angle shape that often curves more inward. A wider jaw angle shape will also make it more defined and often makes it appear a little vertically longer as well.

Male jaw angle augmentation is most commonly done using standard implants for which several types of widening styles exist. Trying to determine what is the right width is not an exact science but the most common anatomic correlation is the width of the cheek. This is not the main body of the cheek (zygoma) but the part of the cheek that lies more directly above the jaw angle…the zygomatic arch. Using either the outside skin or the maximum convexity of the arch in a 3D CT scan, most would say that the width of the jaw angles should not be outside a vertical line dropped down from them.

But regardless of jaw angle implant style the maximal width of them is in the 10 to 12mm range. For most men this will fall within the vertical line drop down noted above. When it does not only a custom jaw angle implant design can do so.

Case Study:  This young male had a prior history of custom extended cheek implants that had long zygomatic arch extensions. The maximal width of the zygomatic arch implants was 8mms. When dropping a vertical line down from his 3D CT scan from the zygomatic arch implant, an 18mm width increase was needed to make the jaw angles proportionate to them.

Under general anesthesia and through intraoral posterior vestibular incisions, the custom jaw angle implants were placed over the bony jaw angles and fixed to the bone with double screws per side.

An 18m wide jaw angle implant seems excessive when looking at the numbers alone. But when considering the increase in zygomatic arch width that had been previoulsly obtained by zygomatic arch implants, a near 20mm jaw and width is not unreasonable.

Case Highlights:

1) Standard jaw angle implants can provide 10 to 11mms of maximal width increase per side.

2) Wider jaw angle implants that add 18mms in width have to be custom made.

3) The one anatomic guideline for maximal jaw angle width is a vertical line dropped down from the point of maximal convexity of the zygomatic arch.

Dr. Barry Eppley

Indianapolis, Indiana

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