How Can Choose The Best Jawline Implant Design?

Q: Dr. Eppley, I was hoping after seeing the videos we would have some modifications to my jawline implant designs. I agree with less is more. Still very uneasy over the unknown. I understand that every patients anatomy is different but would you guys be able to share any before and after photos with me with specification on implant design measurements just so I can see what that looks like, because at this point I really have no idea. Either way I will trust your recommendations and expertise.

A:Your dilemma is a common one in custom facial implant designs. You are trying to understand/determine the external soft tissue effects from an implant design on the bone. But that is impossible to do with any accuracy since everyone’s soft tissue thicknesses are different with varying responses to underlying pressure displacement. This is why there remains as of yet no scientific formula for making that correlation. Thus custom implant designing is a best guess estimate of what implant dimensions have the greatest chance of getting close to the desired patient results.  It also explains why there is a 40% revision/replacement rate in custom facial implants…as the true effects of an implant design are only known after it has been put in. Then the patient now knows the exact implant dimensions that are needed to achieve their ideal result.

In my experience the more the patient tries to figure out what the best implant dimensions are the worse the design usually ends up. Or to put on another way…the patient who exerts the greatest effort in trying to perfect an implant design have the highest revision rates. The main advantage I have over patients is that, after over 1,000 implant designs and surgeries, I have a better feel for the cause and effect relationship between the implant design and aesthetic outcome. That doesn’t make what I choose perfect, just that I am in a better position to do the guessing.

Dr. Barry Eppley

World-Renowned Plastic Surgeon