Custom jawline implants are the definitive method for lower jaw/facial augmentation. By controlling all dimensions of the implant shape it is very much like expanding the bone boundaries of the entire lower jawbone. (specifically the inferolateral border from one jaw angle to the other)
While patients understandably pay enormous attention and put a lot of thought into the jawline implant design, one very important aspect of seeing the aesthetic effect of that design is surgical placement. While positioning the implant on the bone as designed seems straghtforward, it is far from being so. Placing a large implant through three small incisions provides visualization of less then 1/3 of the implant once inside the pocket… quite a difference compared to how it looks on the design.
As a result of this design to surgical placement visual discrepancy it is helpful to build into the design any features which can assist in this important intraoperative step. One such design feature is a midline marker on the chin. This is seen as a vertical groove in the chin portion of the implant in the midline. It is a 1mm indentation in the chin which often confuses patients as they think it is an effort to create a chin cleft…which it is not. Even if one was deliberately trying to make a chin cleft as part of the implant design a much more pronounced indentation would be needed. (and often that would not create an external cleft anyway)
During manufacture this midline indentation is filled with a colored silicone elastomer so that it is easily seen. When viewed through the submental incision during surgery it allows for more assured midline implant placement at the chin area. The chin is always the first step to position and secure in jawline implant placement as that creates the foundation for setting the paired jaw angle parts of the implant into place behind it.
As a general concept in any custom facial implant, not just jawline implants, some of the design features may be aid the surgeon in placement and thus bring a different value to the aesthetic outcome (prevention asymmetry) than the shape and thickness of the implant.
Dr. Barry Eppley