The most common form of total jawline augmentation is the use of standard chin and jaw angle implants. (I did not say it is the best approach, it is just the most common currently) While this can be effective for some patients, it is really a subtotal form of jawline augmentation since it it discontinuous. In essence the corners of the jaw are augmented (chin and jaw angles) but they are not connected. It is independent ‘spot’ augmentation if you will.
Aside from the aesthetic effects of the the chin and jaw angle implants, one of the problems with the use of standard implants is the potential visible transition between the chin and jaw angles. How to connect the two secondarily can be done by a variety of techniques but one of them are uniformly ideal.
Besides making custom implants to connect the chin and jaw angle implants, the material connection I have found the best is to use ePTFE sheets of 2mm thickness. These are placed though an intraoral vestibular incision just behind the mental nerve where the back end of the chin implant and the front end of the jaw angle implant can be safely visualized. Using 2mm cut pieces of ePTFE offers good rigidity for placement but is also adaptable to the underlying bone or implant surface. A companion treatment to the underlying bone-implant overlay implants is soft tissue fat grafting. While injectable fat grafting is far from assured in terms of volume retention, it adds another layer of augmentation that has no adverse side effects.
Total jawline augmentation, by definition, involves placing implants along its entire course. When standard independent chin and jaw angle implants lack a smooth connection between them the options are to either replace them with a custom one piece jawline implant or secondarily place a ‘patch’ between them. A variety of implant materials exist to do so but ePTGE sheets is a versatile and adaptable option.
Dr. Barry Eppley