Custom Jawline Implant Design
Q: Dr. Eppley, I have looked at the first draft of my custom jawline implant design. I would like the jaw angles to drop down further. According to my measurements I need about 31mms downward. What do you think?
A: Thank you for your input on the custom jawline implant design. The only tricky part of your jawline implant design is the vertical increase of the jaw angles. While any increase in the vertical length of the jaw angles can be designed and made, the critical question is whether the overlying masseter muscle will follow the implant downward. If it doesn’t the implant sticks out ay the bottom but the masseter muscle sits above it like a ball…this is probably not the look any patient is going for. There is no exact formula as to how much the vertical length of the jaw angle can be dropped in any patient until this occurs. What I do know is that I have never dropped a jaw angle past 20 mms and even that is risky. Your drawings are probably inaccurate from the standpoint that the measurement of 31mm doesn’t account for the thickness of the overlying soft tissues. So 31mms is probably closer to 25mms. I have started out with a more modest drop of 12mm on the higher side and would be willing to increase it to 18mm. But I think once you go last that there is a real risk of masseteric muscle dehiscence. (there is one at 18mms too but we have to take some risk to get closer to the aesthetic goal)
Dr. Barry Eppley