The definitive aesthetic jaw augmentation method is the custom jawline implant. Standard chin and jaw angles have their role in enhancing the shape of the lower face but they should be perceived as more corner enhancements of the jaw since they are not connected. Besides the ability to create/control the dimensions of the implant preoperatively at these three corners what really differentiates the custom jawline implant is its connectivity.
The obvious benefit of connected jaw implants is that it creates a smooth shape as it crosses the body of the mandible between the chin and the jaw angles. This more optimally creates a complete new jawline. And while this is certainly a benefit it is not the only one that comes from connectivity. Its other major benefit is the ability through this connectivity to change the mandibular plane angle. This well known cephalometric assessment evaluates the relationship between the vertical position of the chin and jaw angles in the side or profile view. While originally used as a tool to assess the occlusal relationship to the jaw bones, it has a significant external aesthetic impact in the appearance of the lower face.
Many patients with short chins and weak jaws have a higher plane angle and a custom jawline implant is the most effective way to derotate (decrease) the high plane angle jaw appearance through vertical jaw angle lengthening and increased horizontal chin projection. This simulates what could have happened if the lower jaw grew to more of what the patient wanted aesthetically. Standard chin and jaw angle implants simply can’t do that as effectively because they lack connectivity.
While the benefits of derotating the mandibular plane angle in the side view are visibly apparent how that influences the front view must be considered. (as this is how patients see themselves more frequently) As the mandibular plane angle decreases the jaw angles will lower and the lower face will become wider or more square. For some patients this may be a very favorable change. But for other faces this may make it look too heavy or ‘blockish’. So just like preoperatively assessing chin augmentation alone you can’t just rely on profile assessments only. The face from different angles must be considered.
Dr. Barry Eppley
World-Renowned Plastic Surgeon