One method for a complete or total jaw implant augmentation is with the use of standard implants. Both chin and jaw angle implants have been around for decades and have a track record of successful clinical use. What has been learned from their use is that jaw angle implants have a higher risk of complications than chin implants for the most basic reason that they are two of them instead of just one. Malposition is the main complication with jaw angle implants as there is no connection between either one so their placement are individual variables with no help in how one side is placed vs the other.
If the risk of implant malposition is doubled at the jaw angles vs the chin then it is fair to say that total jaw augmentation with three standard implants is even higher. I have seen many 3D CT scans from unsatisfactory three implant augmentations and the implants can be seen to be all over the place. The chin is often reasonably placed but it is the jaw angles that end up highly misplaced. Some are so far out of good position on the bone that it is difficult to understand how it was even done or could have happened.
Even in reasonable well placed jaw angles the most common problem is not getting them back far enough. With widening jaw angle implants this may not be so aesthetically problematic. But in vertical lengthening jaw angle implants this creates far more of an undesireed result.
The other undesired effect of three jaw implants is that they are not connected. This means that in the mid portion or body of the mandible there is no implant coverage. Even if the implants do happen to touch these is little implant material overlap and each edge of the implant overlap is feathered. As a result it is very difficult to ever get a smooth connection between the chin and the jaw angles…provided that is one of the key aesthetic jaw augmentation goals.
This is not to say that three implant jaw augmentation can never be satisfactorily done, but when a more ideal approach exists (custom jawline implant), the reason to do is economic (lower cost) not because it has a better aesthetic outcome or lower risks.
The key with using three standard implants for jaw augmentation is patient selection. Trying to achieve a limited or more modest implant augmentation effect and having it done in very experienced hands will help lower the risk of implant malpositions. One will still have to accept that a linear jawline look is not likely to occur.
Dr. Barry Eppley
World-Renowned Plastic Surgeon