Custom Jawline Implant

Q: Dr. Eppley, I’m about 6 weeks after placement of a custom jawline implant. To be honest, I’m not too thrilled about the results and would like to possibly schedule a revision surgery with yourself. First off I’d like to tell you the situation with my custom jawline implant. On the positive side, in terms of the added bulk along the jawline, I think it’s perfect. There are two main issues I have which I would love your feedback on how to improve. The first is that I feel the lateral projection/width of the angles is not big enough. At about the 3rd week after surgery, I think it was at the perfect level. But after a few more weeks passed, I lost that added width and and angularity and now the angles blend in with the jaw, giving my face a big U look, rather than adding any angularity or sharpness. The second is that because I lost the added width at the angles, the newly added vertical length of the chin has my face now with a stretched out/elongated look. While the projection of the chin is fine, I feel the length really needs to be shorten about 1.5mms or so.

Can I ask your feedback on what you would recommend on terms of design to rectify these issues? To get better sharpness at the angle, should we increase just the lateral projection or also increase the thickness?  How do you think would best to handle the chin? Again, the jawline itself looks much better and defined but I would really like to fix the angle and chin issues.

A:  The first thing I would tell any custom jawline implant patient is to wait a full three months before contemplating any revision. It takes time for all of the swelling to subside and the tissues to contract back down around the implant. There is also the accommodation phase of adjusting to a new look. Between all of these factors how one feels at just 5 weeks after surgery may change…I have seen it happen.

That being said, what you have learned is that while computer designing is a great and only way to make a total wrap around jawline augmentation, there is no accurate way of predicting what the final aesthetic result would be. The computer has no innate knowledge of how to make those dimensional changes and that input must come from the surgeon based on his/her experience.

What you do know now is what effect the current design has created. Those dimensions are critically important when contemplating a revision/replacement implant. What would be important to see, and it is of critical importance, is where you started and what you look like now. That information helps gauge how the dimensions of the chin and jaw angles have had an initial impact and will play a critical role in knowing how to change the current implant design.

Dr. Barry Eppley

Indianapolis, Indiana