Can The Lower Third Of The Face Be Vertically Lengthened Without Looking Too Masculine?

Q: Dr. Eppley, good day I wanted to ask if the lower third can be lengthened in a narrow face with a small lower third total height (6.5cm) and if yes by how much. Also can the mandibular region also be supported by an implant for a better result?

And are you familiar with procedures that aim to create a better lower third without making it masculine by making it aggressively looking but just making it look less underdeveloped? (in my opinion a more developed lower third can also be more masculine even if it’s not a very broad chin compared to a overly undeveloped chin, but i think it’s important to get that across well to avoid miscommunication)

thanks and hoping you stay safe

A: If I interpret what you are describing correctly, you are referring to primarily vertical lengthening of the lower jaw. This is not an uncommon design for a custom wraparound jawline implant. The usual amount of vertical lengthening that the tissues will permit is most limited in the chin area in which up to 10mms of vertical lengthening can be achieved. More can be achieved behind the chin but the tight tissues of the soft tissue chin pad will allow stretch so far to be able to get the incision closed over the implant. Attached is a representative example of such an implant design. To provide implant stability on the inferior border of the lower jaw some implant material must come up along the side of the jaw but this adds minimal width.

For patients who require more than 10mms of vertical lengthening in the chin, that is done by an opening wedge sliding genioplasty where 10 to 15mms of vertical opening can be done combined with implant augmentation for the vertical lengthening of the jawline behind it.

Dr. Barry Eppley

Indianapolis, Indiana