If I Get A Custom Jawline Implant Will I Get An Overdone Result Due To My Skin Thickness?

Q: Dr. Eppley, Since our last email, I have definitely been thinking about the custom jawline implant, swaying back and forth and honestly, I would like to have the implant, I believe it will give me a great result.  Like any patient, I am nervous particularly of the outcome of how it will look and just having a foreign body inside me for the rest of my life .Below are various questions:  

1.   When it comes to scarring, particularly on the submental region ,which is where it is the only small incision on the skin, is it possible for the scar to heal to a point where it is undetectable?

2. Is the sensation from the surgery of getting an implant comparable (incisions aside) to getting filler in the jaw and chin?

3.  How exactly do the screws get secured? ( I thought you screwed it in, but I read somewhere that it does it itself?)

4.  With your knowledge and experience, what are some questions that you think I should be asking but am not? 

5. You also mentioned that idea of a neck liposuction to increase the profile of the jawline implant, is a neck lift a possibility too? ( I read that one surgeon “performed a special muscle tuck under the chin with 3D telescopes to achieve a better result than with just normal liposuction. This procedure is done with a small incision under the chin and does not involve incisions around the ears.” Do you use special procedures like this?

6. Is the implant a mold placed over (i.e encircling) the bone or just on top (or along) the bonet? 

7. Post-op, how long do I have to be NPO? Or would I only be on a liquid diet?

8. Would you agree that given the thickness of my skin, I run a lower risk of having an “overdone” look?

9. When you make your imaging/models, do you take into account other facial features such as nose and cheeks? (I ask as I wonder about those who decide to get other procedures later i.e like a cheek implant or rhinoplasty). 

10. Also do you have any thoughts about my jowls?  Would any of these procedures (i.e implant, neck liposuction etc) have any positive effect on that? 

Thank you!

A: In answer to your custom jawline implant questions:

1) Scars can heal to be minimally detectable but there is no such outcome as invisible scarring.

2) There is no comparison to the feeling afterwards from injections to that of more extensive implant surgery. It is very different.

3) I always use screws for implant fixation.

4) You are asking all the right questions.

5) You are referring to a submentoplasty which is a step up from liposuction of the neck. This is a procedure that is done under direct vision through the same submental skin incision as the implant is introduced. Any mention of the use of ‘3D telescopes’ to perform it is a marketing ploy.

6) How the implant fits around the bone is as function of its design, which is not yet completely known. It fundamentally provides inferolateral bone coverage.

7) NPO is what you are 8 hours before surgery, this is not relevant after surgery.

8) The ‘overdone’ look is a function of the size and shape of the implant, not due to skin thickness.

9) Imaging is done to see what the patient wants, not what I want or what I think looks good. It is just a starting point for discussion ti fully reveal what type of change they seek.

10) The implant will definitely improve jowls, particularly the there is a vertical component to the design.

Dr. Barry Eppley

Indianapolis, Indiana