Should I Have The Chin Wing or Custom Jawline Implant For Total Jaw Lengthening?

Q: Dr. Eppley, Thank you very much for your reply, and for taking the time to do the imaging! After investigating the matter in greater depth, and taking into account your feedback and the imaging, here are some thoughts that may help to advance the discussion:

– It would appear that the lack of “strength” I perceive is a result of jaws that are a bit recessed, although not to a degree where they have caused any problems that I am aware of. However, since the issue is merely aesthetic, I question the wisdom of undergoing an aggressive treatment like DJS.

– I believe that chin projection is okay as it is and that moving it further forward would not provide an aesthetic benefit.

– Similarly, I don’t have a problem with the width of my jaw and feel that increasing it would change my face more than I would like.

– The main goal is, I believe, to moderately increase the height of the chin and the entire jawline. I originally considered a genioplasty to augment ching height but discarded it for two reasons. The first one is that I’ve been told that it leaves a step in the jawline which can be visible and certainly felt. The second is that it would give the appearance of a longer/narrower face, which is something I would not like.

– My conclusion so far is that I seem to be seeking a result along the lines of what could be achieved with a chin wing procedure that only adds height, without any forward movement. Would you agree with this, based on the previous comments? Is this something that Dr Eppley performs, or is it something that can be replicated through customized implants?

Again, thank you very much for your help, and hope to hear your thoughts.

A: I think we both agree that vertical jawline lengthening is the correct aesthetic goal to which there are 3 ways to try and achieve it with varying effects along the length of the jawline:

Vertical Bony Chin Lengthening – affects chin area only (a 1/3 jawline augmentation procedure)

Chin Wing Osteotomy – affects chin and body of mandible (a 2/3s jawline augmentation procedure)

Custom Jawline Implant – affects the total jawline from chin to jaw angles.

With that understanding the chin wing is a good procedure as long as you understand it will have no lengthening effect on the jaw angles. Once you understand where the osteotomy line is (see attached)  it becomes clear it provides no improvement at the jaw angles and its effect fades as one moves back from the chin. In essence it is a 1/2 or 2/3s jaw lengthening procedure.

Dr. Barry Eppley

World-Renowned Plastic Surgeon