Can A Custom Jawline Implant Be Made To Largely Create Vertical Lengthening With Minimal Width?

Q: Dr. Eppley, I have an inquiry about custom vertical jaw lengthening implants. I have downward swung jaws that make my lower third somewhat long, my gonial angle very high, a short ramus, and very steep jaw (40 degrees). As far as the implants on the jaw go I have 2 questions. 

1. Can these implants be created with minimal width expansion? I am not too worried about my jaw width, I don’t need or desire a jaw as wide as my zygos. 

2. This is my largest worry: Will the distance the jaw/gonion is lowered translate to the most outward point on my jaw from the front lowering the same amount? I worry that lowering my gonions 1 – 1.5cm will cause my lower face to look blocky and bloated from the front since my somewhat long chin will still exist but now my jaw angles will be below my mouth. Is there any implant design method that can lengthen my ramus but not severely change jaw angle placement? 

I am really considering this procedure along with sliding genioplasty in the next year but this second point of contention has me extremely worried. 


A: Because they are custom jawline implants they can be made however one deems appropriate. The usual minimal width of material is 3mms. As a general rule few patients with high jaw angles need or are advised to go 10 to 15mms on the vertical jaw angle drop for the very reason you describe as well as the high risk of masseteric muscle dehiscence.

Dr. Barry Eppley

Indianapolis, Indiana