While individual chin and jaw angle implants make up the majority of lower facial augmentations, the use of custom jawline implants is steadily growing in use. Offering a total jawline approach, these wrap around implants cover the entire lower jaw from angle to angle crossing the chin anteriorly. No other implant approach can rival the changes that an implant that covers this much skeletal surface area can do.
But a custom jawline implant by virtue of its size can make its placement challenging. When placed onto the face it can seem daunting as to how it should be surgically placed as a single piece unit. It seems too big to be introduced through just a single submental or intraoral incision. So how does one place a custom wrap around jawline implant as a single piece unit?
The proper placement of a custom jawline implant is through a three incisional approach. The anterior incision can be either a submental or an anterior intraoral vestibular incision. But two or bilateral posterior intraoral vestibular incisions are needed to properly place the jaw angle portion of the implant. It is extremely important to check the position of the jaw angle portion to be certain it is properly seated against the bone. Only direct inspection can assure that it is.
Because a silicone custom jawline implant is flexible when not on the bone, it can be folded and threaded through a soft tissue tunnel below the exit of the mental nerve. Whether this will he successful or not depends on the size and thickness of the jaw angle portion of the custom jawline implant design. Very thick and large jaw angle portions may necessitate a split of the implant into two pieces threaded in from back to front and the joined in the middle. But if the jaw angle portions are not to big, they can be folded in front the front and kept as a single one piece wrap around implant which can be fixed at the chin with a single or double screw.
Dr. Barry Eppley
Indianapolis, Indiana