Do I Need A Custom Jawline Implant?

Q: Dr. Eppley, I am interested in getting a custom chin/jawline implant. I’ve been doing some more research into cheek and chin implants and wanted to ask your advice. Based on my photos do you think a standard  chin implant modified to fit just the left side would be adequate? Or is it best to stick with the plan for a custom implant? I know a custom implant would be pretty pricey and since I’ll be needing lots of other work done to correct my Parry Rhomberg syndrome so I’m just trying to figure out the best options. I also wanted to get your thoughts on cheek implants. One surgeon I spoke to thought I only need a cheek implant on the left side and that the right side could be built up with fat or filler. However another surgeon insisted that I needed implants on both cheeks, so now I am confused. Would you suggest a cheek implant just on the left side or both sides to make things as symmetrical as possible? I’ve attached the other surgeons photo simulations of a standard chin implant, fat transfer, and left side cheek implants. Do these simulations seem like attainable results to you?  Any feed back would be greatly appreciated.

A: With facial bone asymmetry, it is a given that a custom jawline implant would be superior to any off-the-shelf implant. There is no question about that. The question you are asking, understandably, is there something that would cost less that could do a reasonably similar job as a custom implant. When it comes to any existing standard chin implants I would say no because the bone deficiency extends all the way back to the jaw angle. However, I have been using a new wrap around jawline implant for men and women that I believe would work that is not yet available to the general public. (sold by the manufacturer) I think half of this implant could be added from your left chin back to the jaw angle and would do a great job of building out your deficient chin-jawline. (the custom implant would probably look somewhat similar) This would reduce the cost of the procedure considerably over a custom jawline implant.

As for the cheek areas, go with cheek implants on both sides. The cheek implants would not be the same size of course. But never try to compensate for a skeletal deficiency with unpredictable fat grafts when you are already committing to doing a cheek implant on one side. You may still need some fat grafting but just don’t try to make it work for the bone part of the facial problem when there are more predictable solutions.

When it comes to computer prediction imaging, understand that it is not a guarantee of how the surgery will turn out. It is Photoshop where anything is possible by moving pixels around. It is the surgeon’s estimate of what he/she hopes is accomplished and is the goal to aim for but whether that is completely attainable is determined by the surgeons skill and ability and how realistic the imaging has been done.

Dr. Barry Eppley

Indianapolis, Indiana