External Effects of Facial Implants

Q: Dr. Eppley, When it comes to the “short face syndrome” characterized with a shorter lower third compared to middle and upper third, this is often present without any problems in chewing or overbite / upperbite.

In my case, my maxilla is very forward (almost as forward as the likes of Jordan Barrett) but my jaw is small. It is not micrognathic nor retrognathic but just slightly smaller than average. I mean to say that it is short, narrow, and lacks forward projection (lines up with the hollow of the nose but not further than the lips). My bite is okay (class 1 with one or two crooked teeth) as is my breathing etc my only concern is aesthetic

Would your advice to someone who wants peak esthetic modification to be made to their jaw be to have the orthognatic surgery (cosmetic only, and expensive as hell) to fix this JAW OR

Just be to opt for either a simple osteotomy like a genioplasty, or implants like your big ones that fill up around the jaw and chin.

The other reason I am not too certain on the implant route is because they give a “bloated” look in a lot of cases, although I would not be surprised if it turns out that an orthognathic surgery would do the same thing.

I am curious what makes this procedure look so angular and sharp:

https://exploreplasticsurgery.com/wp-content/uploads/2016/02/Custom-Jawline-Implant-result-frofnt-view-Dr-Barry-Eppley-Indianapolis.jpg

When these ones were still effective but you can see they look a bit “bulkier” and less angular:

http://www.customfacialimplants.com/photos/custom-implants/customimplants36.jpg

https://exploreplasticsurgery.com/wp-content/uploads/2017/01/Custom-Jawline-Implant-Replacement-of-Medpor-Implant-result-front-view-Dr-Barry-Eppley-Indianapolis.jpg

One user on a board I frequent (and if you know the website Lookism, you know it’s filled with nonsense) theorized this is because of the material of the implant and that silicone gets “squished” by the tautness of the soft tissue. Others theorized it’s because of the masseter muscle.

What made the implants that I linked in that picture so effective when the others looked “bulky”?

Thanks so much for your time.

A:There are many variables that go into what happens with the external facial appearance after any underlying implant or bone moving procedure. But the most important one is the patient’s natural soft tissue thickness. In short, angular faces end up with greater defined results. Fuller faces do not usually get angular just bigger and fuller. The best analogy I know is lip augmentation. Full lips get nicely fuller with any form of augmentation. Thin lips never get nicely fuller no matter what is stuck in them.

Dr. Barry Eppley

Indianapolis, Indiana