Jaw angle implants have become more common as the appreciation of the jawline behind the chin has become more aesthetically appreciated. While this is very popular amongst men where stronger jawlines have always been valued, it is has become popular amongst women as well today.
A stronger jawline in a woman has a different look than it does in a man. Besides more of a v-shape to the chin the shape of the jaw angles is also different. The focus is more on having a more defined jaw angle shape but not necessarily that of a lot of increased width. Much like the overall shape to the chin a good female jawline appears with a well defined but still not overly wide jaw angles.
As a result, more times than not, the proper standard jaw angle implant needed for women is of the vertical lengthening style. Unlike the traditional widening jaw angle implant, a portion of the implant extends below the natural inferolateral border of the posterior ramus. As is needed the main portion that elongates the jaw angle is right over the jaw angle point. (intersection of the posterior and inferior jaw angle borders) This is how the jaw angle becomes visible with a more defined shape. The thinner the overlying tissues the more evident the extension of the jaw angle (implant outline) becomes.
All styles of jaw angle implants are placed through an intraoral approach and the vertical lengthening style is not exception. The keys to a successful aesthetic outcome are three-fold. First the soft tissues (masseter muscle and periosteum) must be carefully elevated off and around the jaw angle point. Failure to do so will result in an implant sitting too high, resulting in an ill-defined widening effect and probable jaw angle asymmetry as well. Secondly the implant must be positioned done and over the jaw angle point so that it creates a true elongation of the bony border. Thirdly holding the jaw angle implant in the desired position requires screw fixation. And the most secure type of fixation is the use of two screws. (to prevent implant rotation)
Vertical lengthening jaw angle implants can simply not be used if screw fixation is not employed. Without screw fixation the jaw angle implant will be pushed back up from its intended position resulting in loss of its intended jawline reshaping effect.
Dr. Barry Eppley