The most dramatic and successful augmentation of the entire lower third of the face is best done in most patients by a custom jawline implant. Such an implant is made from a 3D CT scan of the patient. Inserted as a single piece implant that augments the lower face from jaw angle to jaw angle, it can create a a wide range of jaw shape changes.
While the custom design process has many advantages, it is not a perfect aesthetic jawline procedure. This is because the computer nor the surgeon can know exactly how the design will really look on the patient. This is no accurate method to know how the jawline implant design and dimensions will translate to an external facial change in appearance.
Three is also the variable that even the patient does not really know how they will react to the jawline shape change. What one thinks they may have wanted can change when one actually sees it on their face. There is also the issue that some patients may be happy with their custom jawline implant result but may decide later that they would like some change in its design for additional enhancement.
Thus, a custom jawline implant does have the risk of revisional surgery which is almost always for an aesthetic reason. Such revisional custom jawline implant surgery does have several issues that are somewhat different than the initial implant placement. These can impact the recovery period and the attainment of the final aesthetic result.
While the computer can make any change in the implant’s design, placing the new custom jawline implant can be challenging in some cases. This is mort relevant when the implant is bigger than the initial design. Because the tissues have created an enveloping layer of scar tissue (capsule), it is not just as simple as ‘removing the old implants and slipping in a new one’. The capsule must be either released (capsulotomy) or removed (capsulectomy) to create the necessary space (pocket). This maneuver can be quite challenging in the tight space of the jawline implant pocket which uses small incisions to create and/or modify it.
Because of the difficulty in adequately opening up the capsule, a new custom jawline implant may create more swelling and bruising than the first one. It may also take more operative time than the first operation. It requires patience and diligence on the part of the surgeon to get the new implant properly positioned.
Dr. Barry Eppley
Indianapolis, Indiana