Custom Jaw Implant

Q: Dr. Eppley, I’m thinking about having a custom jaw implant or a custom wrap around jawline implant. I’m a male who has a round short chin with a smooth jaw. I want my lower third of the face to be longer and wider. Not so much of a horizontal projection on chin but a significant vertical height and definitely a square,defined chin. So I roughly measured the projections I want myself. They are:

Chin width 4cm – 4.5cm not mm

Chin vertical projection 8mm – 10mm

Chin horizontal projection 3mm

Mandibular vertical projection 1mm – 2mm

Mandibular horizontal projection 5mm

Do you think this dimensions are realistic or achievable? And thank you for your consideration!

A: In answer to your questions about your proposed jawline implant dimensions I would make the following comments:

Chin horizontal projection – 5mms (yes)

Chin vertical increase – 5 to 10mms (5mms is more realistic)

Chin width increase – I not sure whether you mean in addition to your natural chin width or that this is the amount you want added. The former is very possible, the latter is too extreme as the side tissue can not be stretched that much. (Maybe 1 cm per side)

In the chin area of the jawline the soft tissue chin pad is much more restrictive in allowing it to be expanded than in the back part of the jaw. This is particularly relevant in vertically dropping of the chin. If you want a 10mm increase with the other chin changes, I would also consider doing an opening vertical bony genioplasty of 10mms (this carries the soft tissue chin pad down better) and placing custom extended jaw angle-lateral chin implants to accomplish most of the other changes.

What I would also say about the chin width is that most patients, understandably, can’t appreciate the impact of measurements that they take on the outside of their face for what an implant size should be. That often over estimates the impact of such skeletal augmentations on the face. In my experience, if patients were left alone to devise the implants based on measurements they believe would work, all such implants would be too big. One of my tasks in custom facial implant designing is to help avoid that aesthetic problem or other more significant problems that can come from very large implant dimensions.

Jaw angle width increase – 5mms (yes)

Jaw angle vertical increase – 2mms (yes)

Dr. Barry Eppley

Indianapolis, Indiana