A custom jawline implant is the most effective and comprehensive approach to augmenting the lower third of the face. Its wraparound design creates a new lower jawline shape from angle to angle. It combines three components of the jawline, the chin, jaw angles and the connection between them, into one single implant.
But what is not immediately obvious is how is such a large jawline implant surgically inserted. Standard chin and jaw angle implants are placed through single intraoral or extraoral incisions but such a single and limited incisional approach will not work for the size of a custom jawline implant.
A custom jawline implant requires a three incisional placement technique. This is done with a single anterior (submental skin or intraoral vestibular) and paired or bilateral intraoral posterior vestibular incisions. In essence it is the same as putting in standard chin and jaw angle implants as a combined approach. But with one exception…the custom jawline implant is one big implant not three separate smaller ones.
The larger jawline implant can still be inserted as a single piece provided the jaw angle portion is not too big. The key to placing a custom jawline implant as a single unit is that it has to pass through a narrow tissue tunnel below the mental nerve between the chin and jaw angle pockets. (a front to back placement technique0 To do so the larger jaw angle section of the implant must be capable of being folded for insertion through this tunnel. In my experience if the thickness of the jaw angles are bigger than 7mms then it is not usually possible.
If the jaw angle portions of the implant can not be folded and inserted safely beneath the mental nerve, then the implant must be sectioned into two pieces and inserted in a back to front technique. (being reassembled once in place in the midline of the chin)
Dr. Barry Eppley
Indianapolis, Indiana