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A custom jawline implant provides a comprehensive augmentation of the entire lower face. Placed through a triangular incisional technique the subperiosteal tissues are dissected and the positioning of its three ‘corners’ is done under direct vision. What i not obvious in this process is that all three incisions are fairly small and such of the implant is not really seen. Because it is a very long implant numerous aspects of its positioning on the bone must be checked and the very first one is whether the chin is in the midline.

To help with midline positioning of the chin, seen either through the submental or intraoral incisions, a vertical groove is placed through the implant in its design. This frequently confuses patients as they think it is going to create a vertical chin cleft postoperatively. This vertical groove in the implant is only 1mm deep and could not possibly create a cleft. Even if the implant had a vertical groove that went completely through the implant an external visible chin cleft could not be created. Creating a vertical chin cleft requires far more effort than a physical indentation in an implant or the bone.

When the implant is manufactured this midline groove is often filled in with a blue colored silicone elastomer material.  This helps further with its visualization and alignment. This alignment is not only for the midline positioning but also for horizontal orientation. Just like an extended chin implant the long sides of a jawline implant can easily develop horizontal tilt.

Ideal placement of a custom jawline implant is not easy with the restrictive limitation of the small incisions. A midline chin marker is an obvious implant design feature that is but one aid in the intraoperative placement process.  

Dr. Barry Eppley

Indianapolis, Indiana

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