Q: Dr. Eppley, I am specifically looking for angle of the mandible implants (jaw angle implants) to increase the width of my jaw as well as increasing the vertical height to give it a more angled, defined look to my otherwise high, weak jawline. I am wanting to have a simultaneous chin implant to compliment the jaw implants.
While I can find endless information on chin implants, jaw angle implants seem rather non-existent and very few plastic surgeons perform them which has me a little apprehensive as to why this is. Would you be able to tell me more about this wrap around style implant and the advantages/disadvantages of having this over a simultaneous angle of the mandible/chin implant?
A: The history of chin and jaw angle implants are quite different even though they are located on the same bone. Chin implants are ‘end of the bone’ augmentations that are easy to predict the outcome, simple to place and have minimal morbidity and recovery because the overlying muscle and soft tissue cover and disruption is small. The first chin implant was developed in the 1960s and was and continues to be the most recognized and important bony facial profile enhancement technique. Chin implants have gone through many different designs and shape changes over the years to meet the differing needs of many different types of aesthetic chin problems.
Jaw angle implants, conversely, are very much the opposite of chin implants. They are ‘middle of the bone’ augmentations whose aesthetic reqiurements are harder to predict, require more skill and experience to place, and have more morbidity and recovery because the largest muscle on the face (masseter muscle) is being disrupted.The first jaw angle implant was introduced in 1995 without any design changes since then…with an original design (width only) that is inadequate for most patient’s jaw angle deficiencies. (vertically short)
With an increasing public demand for more complete jawline enhancement, there is a need for neeawareness offew surgeons however have ever performed them or had any training to do so. My experience with jaw angle implants and overall jawline enhancement in general is considerable as I have focused on changing how jaw angle implant surgery is done through new implant designs and the surgical techniques in placing them.
The fundamental difference between using a preformed 3-piece or a custom one-piece jawline enhancement is the connection between the chin and the jaw angle augmented areas. If one wants a perfectly straight line between the chin and jaw angle, then a custom jawline implant is the approach of choice. Custom implants are also needed when the dimensions of the jawline changes are desired exceeds the size or shape of what is available ‘off-the-shelf’.
Dr. Barry Eppley