Custom Jawline Implants

Q: D. Eppley, I have some technical questions about custom jawline implants. The implant looks like solid silicone. Do you divide it in the midline for insertion? Do you use any screw fixation or just close the periosteum over these implants? Is your incision strictly transcutaneous or do you incorporate buccal incisions as well?

A: In answer to your questions:

1) All custom jawline implants require a three incision placement technique. (2 posterior vestibular and 1 anterior, submental or intraoral) It is a biggest facial implant that can be placed and requires multiple incisions to be inserted.

2) If the implant has large jaw angles, it needs to be divided in the midline and inserted in a posteroanterior approach to eliminate the risk of mental nerve injury. The key to a single for split custom jawline implant is the size of the jaw angles and how easily they can be folded during insertion.

3) If the implant has smaller jaw angles that can be easily folded it can be inserted as a single piece in an anteroposterior method.

4) The implants are placed in a completely subperiosteal pocket.

5) A three point microscrew (1.5mms) fixation is used at the chin and jaw angles.

Dr. Barry Eppley
Indianapolis, Indiana