A custom wraparound jawline implant is a supercharged chin implant that augments the entire jawline. As a result it shares some similarities in placement as both type of jaw implants need an anterior incision. (the total jawline implant also needs two additional intraoral incisions to get the jaw angle parts in the proper position) This anterior incision can be done from either an intraoral mucosal approach or through transcutaneous access from under the chin. (submental incision)
Most men prefer or are not bothered by a submental incision due to their beard skin for either their chin implant or custom jawline implant. The typical location for the submental skin incision for standard chin implants is in the submental skin crease at the junction of the chin pad and the neck. For custom jawline implants that don’t have a significant chin component this standard submental skin incision location is acceptable. But in larger custom jawline implants this location poses a problem.
A custom jawline implant, because of the surface area that it covers, can have a powerful effect on overlying tissue expansion. While in the jawline and jaw angle areas this tissue expansion effect is completely beneficial, in the chin this tissue expansion has an impact on the incision location. Since this tissue expansion effect recruits tissue from the new up onto the jawline, a standard submental skin incision location can result in the incision ending up on the edge of the chin during closure and being visible.
For this reason it is recommended that the submental skin incision be more posterior, about 1 cm behind the skin crease. The incisional ‘advancement’ after implant placement will then still be under the chin and not up on it. The larger the horizontal chin component is of the implant the more relevant this issue becomes. Similarly this also applies to vertical chin lengthening of the implant which actually as a more profound effect on potential incisional migration than the amount of horizontal augmentation does.
Dr. Barry Eppley
Indianapolis, Indiana