Custom Jaw Implant
Q: Dr. Eppley, I am interested in a custom jawline implant. One year ago I had jaw surgery and a sliding genioplasty. I had a receding chin and an overbite so it was recommended o have my jaw brought forward and have a sliding geniplasty instead of a chin implant. The surgery was certainly not fun and I was very swollen for many months. Six months after the surgery I was happy with how my face looked but as the swelling further reduced my face became more narrow and asymmetrical. I ended up with a very narrow asymmetric face and a very pointy chin. This was devastating for me as this was not how I envisioned I would look. I thought I would get a stronger more chiseled jaw and mandible as this is what the surgeon told me! But I ended up with a very long and narrow looking face.
I consulted another surgeon to ask about getting implant/implants to fix the asymmetry but he didn’t recommend it. He recommend fillers or a fat transfer. I ended up getting fillers but the asymmetry was so much (and the volume loss on the right side) that I had to have six treatments. It was expensive and I still wasn’t happy with it. I’m looking for a permanent solution.
A: Thank you for your inquiry and detailing out your surgical history and current concerns . While moving the chin and mandible forward does enhance anterior skeletal projection, it almost always does so at the expense of width. (A U-shaped structure that comes forward in two places will be more narrow….this is magnified when the surgical trauma and swelling causes soft tissue atrophy) While an effort at injectable treatment was worthy of the effort, to prove to yourself what the results would be, it never was a long-term solution. In addition, no form of fillers or fat can create skeletal highlights or angularity, all they can do it makes things puffy and round which is why they rarely are effective for jawline augmentation.
It would seem by your concerns and pictures that custom jaw implant would create the missing chin and jaw line dimensions. This is done using a current 3D CT scan. This is also an excellent method for improving any bony asymmetries since the computer design process can make those adjustments done to the 1mm level.
Dr. Barry Eppley