Q: Dr. Eppley, I am interested in jawline enhancement surgery doing a sliding genioplasty and jaw angle implants. Can the chin surgery be done at the same time as adding jaw angle implants? Would these custom implants be of a material that would be able to last a lifetime? I’m only 25 years old and have already gone through so much with my jaw and teeth that I wouldn’t want to go through with another surgery, but I am very unhappy with the way my face looks currently. I think that a sliding genioplasty with the jaw angle implants would be ideal because I agree that my chin looks rather long and I would rather adjust/fix it than add a chin implant. I know that this isn’t a consultation but what would be approximate cost be for these operations…10-12k or over 15k? I am currently covered under Tri-care but I know that these would be considered cosmetic and probably nothing would be covered with insurance.
A: In answer to your jawline enhancement surgery questions,
1) A sliding genioplasty and jaw angle implants can and should be done at the same time.
2) All facial implants are made of non-biodegradable silicone material which will last much longer than you and I will.
3) I thin the best approach in you would be a sliding genioplasty and vertical lengthening jaw angle implants. The most ideal approach for the implants is to have them custom made because you probably have some degree of asymmetry between your jaw angles given your prior surgery. But in the interest of cost, semi-custom vertical lengthening jaw angle implants can be used.
4) I will have my assistant pass along the exact cost of the surgery to you tomorrow.
5) Unfortunately your assumption is correct in that this would not be considered a medically necessity and would be viewed by TriCare as an elective cosmetic procedure.
Dr. Barry Eppley
Q: Dr. Eppley, I am unhappy with my nose and I have been considering rhinoplasty for a while as well as jaw augmentation. For my nose, my first main concern is that I don’t like the bulbous tip it has. I’d like the tip to look pointier and to project a bit more. Second, I think my nose is too wide. I would like my nostrils to be narrower from the front view. I have attached a few photos of my face, as well as a couple models whose noses I like.
For the jaw, I have been considering some combination of chin and especially jaw angle implants. Perhaps even sliding genioplasty, the latter I understand is the only way to add vertical chin height. I basically want to create a stronger looking profile that balances my face.
I also have a few secondary procedures I am considering but not sure about. A reduction of my lower lip reduction (I think it is too big compared to the upper, and might make my chin appear larger if it were reduced). And also forehead augmentation (to reduce the appearance of my sloping forehead/prominent brow bone)
I am trying to figure out which procedure/s would produce be the best result in my case.Would it even be possible to do all of them at once?
A: Briefly, all the facial procedures you have discussed can be done as the same time and it would not be rare in my experience to do so. But first we must go through each procedure and determine what is the best approach for each change and how much change you desire for each area. Options in rhinoplasty and jawline enhancement are best done through initial computer imaging. I will do some computer imaging using your pictures of these changes and this will be a good starting point for our treatment planning discussion.
Dr. Barry Eppley
Q: Dr. Eppley, I looked through your blog but didn’t see this question so I thought I would ask you here. I know jaw augmentation has a high rate of swelling, so I wanted to ask; do you recommend someone wear a facial compression garment for say the first 4 or so days to help with this or would this not help/ be a hindrance to the healing process? Also, would taking something like Arnica montana and Bromelain be of any use in swelling/ bruising( from what I’ve read on some surgeons websites ). Thank you for your time.
A: Thank you for you inquiry about the management of swelling after any jaw augmentation/jawline implant enhancement procedure. While there may be no detailed information in my blog to date in this topic, there will be now.
Jaw augmentation can potentially cause some of the most proportionate swelling on the face after surgery. This is because it requires lifting up much of the outer portion of the masseter muscle to place the implants. Because the masseter muscle is the second largest muscle on the face (the temporalis is the largest and is more on the side of the head than on the face), any disruption of its attachments can cause some profound swelling. The amount of that swelling is partially affected by the extent of the muscle elevation and how the tissues are handled. But there is no getting around the fact that there will be some substantative muscle edema and swelling.
Knowing this in advance, steroids are given intravenously during surgery as a pharmaceutical management strategy. This is probably the most effective strategy for reducing the amount of swelling that would otherwise appear. A compressive wrap is placed after surgery for the first 18 to 24 hours and is taken down the next day. This, like steriods, is about steroid control not resolution. Any wearing of the compressive wrap beyond that time period is more for comfort and has not been proven to help swelling go down any faster. Arnica and Bromelain are homeopathic agents that are commonly touted and used after plastic surgery procedures as anti-bruising and anti-inflammatory modalities. While they are certainly harmless and inexpensive, no scientific controlled study has ever been done that provides conclusive proof of their benefit. But their lack of any side effects makes their use of, at least, some psychotherapeutic benefit.
Beyond what is done during and immediately surgery, time and healing is the only really effective agent that ultimately eliminates swelling after jaw augmentation.
Dr. Barry Eppley
Q: Dr. Eppley, I would like to know if you actually do silicone drop down jaw angle implants. Where I am from not many people do it here. I am not a big fan of Medpor. Roughly how much would you charge for this procedure as I am saving up. Let’s say if you do have a drop down silicone implant can one get a few mm width as well? Iwould like a bit of a square look from front but not too extreme as I have a skinny skeletonized face? On the picture I have uploaded my right side jaw as without the beard I do not like the shape of it. I would like the jaw angle to go back towards my ear and possibly a small drop down so my face does not look too long. Personally I think my chin is fine and my jaw isn’t too bad as some peoples but I’d like it to be more square from the front and from the side. I have also took a picture of my front face and as you can see it is a bit more chiseled. I am hoping I can achieve this look like in my after picture since my face is skinny. I’d preferably like silicone.
A: The concept of vertical lengthening jaw angle implants made of silicone is one of which I am quite familiar. Historically silicone jaw angle implants could only add width and not vertical length, a flaw in their basic design. Snce most patients that want jaw angle augmentation have a high jaw angle position, vertical lengthening is one of their most important dimenions. I am working with a major silicone facial implant manufacturer on these new jaw angle implant designs which will have various length and width dimensions to them. With a silicone material these implants will be easier to insert as well as revise/remove should that be necessary.
Dr. Barry Eppley
Q: Dr. Eppley, 1. Am interested in an overall approach to address my weak jawline/chin and nasolabial folds. I had a smaller chin implant over 20 years ago, but I am certain that advances since that time could provide me with a better overall result.
A: I have received your pictures and done some initial imaging predictions. Knowing that you have a chin implant in place with your high jaw angles indicates how short your lower jaw really is. Substantial improvement can come by changing all dimensions of the jawline, not just the horizontal position of the chin. There are two fundamental approaches. A sliding genioplasty combined with an extended chin-jawline implant overlay with vertical lengthening jaw angle implants is one option. The second choice would be a custom total wrap around jawline implant made from a computer-generated design off of a 3D CT scan. There are advantage and disadvantages with either method. Either approach takes it way beyond what the simplistic approach of ‘chin augmentation’ would achieve by looking at a complete jawline enhancement. As you know, your lower jaw issue is not just a simple isolated chin deficiency.
Dr. Barry Eppley
Q: Dr. Eppley, You suggested 10mm of vertical projection for both my jaw and chin. However, when I measured my face with a ruler, I determined that in order to achieve the 1/3 1/3 1/3 ratio, I would need between 15-20mm vertical lengthening. I am hoping we can design a chin implant that has close to 15mm of vertical length. In my experience am more worried about undershooting than overshooting. Is a 15mm vertical chin possible? If so, does it carry increased risk?
2) Can we use computer imaging to figure out the ideal dimensions? My left jaw projects significantly more than my right jaw.
3) With a custom 3-piece chin + jaw set that includes both vertical and horizontal projection, will there be a smooth transition in the space between the chin and jaw(body)
4) In terms of safety, what is the difference between my current Medpor implants and silicone? I heard that silicone breast implants may rupture.
5) Can silicone be flexibly shaped to my jaw contour using hot sterile saline the way Medpor can? And if so, would that mean that the easiest approach is to use a previous patient’s custom implants, and skip the CT scan?
6) How much vertical lengthening do my 7mm Mandibular Matrix jaw and chin implants already have? I can’t find the vertical jaw dimension online.
7) Since my current Medpor implants have been screwed in, how will you remove them? Do you “unscrew” them? I believe there are two screws anchoring each one of the pieces.
8) How many custom combined jaw+chin procedures have you done in the past? Are you the only one who does this?
A: In answer to your questions:
1) The vertical length of the jaw angles can be lengthened in the range of 15 to 20mms. The chin can not be done as much because of the lack of adequate soft tissue to recruit for coverage. A more realistic lengthening in 8 to 10 mms.
2) 2) Computer imaging is great to provide a general concept or trend but it would not be an accurate way to determine the desired millimeters of change. Unless the picture is taken so that the computer recognizes its size, it can not be used for estimating exact changes.
3) One of the main purposes of a custom 3-piece jawline implant system is to have a smooth transition between the chin and the jaw angles.
4) There is no danger is using silicone as a
facial implant material. It is a solid material unlike silicone breast implants. I ma not sure where you would get the concept that a silicone facial implant would rupture.
5) Silicone always adapts better to the bone than medpor. Medpor is a very stiff material that is minimally adaptable using ‘hot water’. This is not necessary with a silicone material.
6) It is impossible for me to say how much vertical lengthening your current implants provide since that is highly influenced by how they were placed in addition to their design.
7) Your current implants have to be unscrewed…that is the easy part in trying to remove them.
8) I have been making custom facial implants for 20 years. I can’t speak for who else may use this approach around the world.
Dr. Barry Eppley
Q: Dr. Eppley,I am a 27 year-old man currently looking for the best surgeon to carry out jawline and perhaps chin augmentation. I would love to get rod of this beard which I sue to camouflage my weak lower jaw. I have added you on Skype for a consult and have attached some pictures for your review.
A: I have done some imaging on your pictures. Yo do have a very short chin and high jaw angles. I don’t think a chin implant alone would suffice for the change that I have imaged. The concept of a sliding genioplasty with an overlay small square chin implant can create a 12 to 13mms of horizontal increase and add more squareness to your chin from the front view. Your jaw angles need vertical lengthening only with a minimal horizontal increase. All put together this should create a dramatic change in the jawline that will make you be able to dispense with the beard if you so desire.
Dr. Barry Eppley
Q: Dr. Eppley, I am a 21 year-old transsexual male. (female to male) I have been on hormones for a year and a half and my face has changed in sufficient ways. However, I still lack much masculinity in my facial features, and the bones don’t face drastic changes at my age. I also know that I have a bulbous tip to my nose and a weak chin. I have been considering plastic surgery not only for aesthetic reasons, but for the more masculine appearance I could gain from it. My goal isn’t to correct the flaws in my facial balance as much as it is to “masculinize” it. A strong chin, a strong straighter tipped nose would be my goals. I am wondering if you think you could achieve what I am asking of you. I can send pictures and you could give me your input. I will send them from different angles, completely neutral appearing. Thank you for your help in this matter.
A: As a general statement about facial gender transformation, it is usually easier to make a face appear more masculine than more feminine. This is because augmentation of the facial bones, usually by implants, can produce a more noticeable change than trying to reduce the size of any facial bone. This, of course, depends on the facial bone structure that one has to work with but augmentation by millimeters will always be greater than what bone reduction in millimeters can be achieved.
In making a face more masculine the jawline is always of great importance. Whether it is just chin augmentation or a more complete jawline enhancement including jaw angle implants, one of the defining male features is a strong jawline. While the nose is not as important a male feature as the jawline, a nose and a rhinoplasty that creates a high dorsal line and a well defined tip goes along with a good jawline that makes a very masculine statement in profile. Computer imaging will show how much of a difference these changes can make in the appearance of your face.
Dr. Barry Eppley
Q: Dr. Eppley, I want to achieve a more masculine jaw line. My face is oval and I want a more square cut lower face. I had a chin implant back in 1990 with a rhinoplasty. Would like to know what my options are and also would this implants just be inserted or are they secured with screws. How many days do I have to stay inIndianapolis before flying back to home. Thanks so much for your fast response.
A: Thank you for sending your pictures. I did some preliminary imaging based on what I perceive as your desire for a more masculine jawline. This was done using a combination of chin and jaw angle implants, the most common approach to make a circumferential change to the jawline. One interesting issue with you is that you already have a chin implant and the change to get you to the imaging result is significant. This raises the question of whether an off-the-shelf (stock) chin implant can really achieve that goal of which I have doubt. This leaves the possibility of either making a custom chin implant or doing a combined sliding genioplasty with a small square chin implant placed in front of it for the square width effect.
All facial implants are always secured by screws for stability of position on the desired bone position long-term.
No matter how it is done, you would be returning home 48 hours after surgery.
Dr. Barry Eppley
Q: Dr. Eppley, thank you for doing the imaging on the predicted changes from chin and jaw angle implants. I am blown away that this can actually be done. This is well beyond my expectations. What size implants would you be using for my jawline enhancement?
A: Quite frankly more extreme changes than those can be done but I kept at the limit of what I see as reasonable and not excessive. (I have attached some results so you can see how extreme it can be made if one wants…although I don’t advise that on you). Your imaged look can be approximated by a combined square chin implant (style II square 9mms) and bilateral jaw angle implants (lateral augmentation style silicone 11mms or Medpor lateral augmentation of 7mm size). If the chin would benefit by vertically lengthening as well, I would do a chin osteotomy for lengthening 5mms and bring it forward 7mm with an overlay of a small square chin implant style II of 3mms.
Dr. Barry Eppley
Q: Dr. Eppley, how much do jaw implants cost roughly? If someone already has a decent jawline but would like to enhance it would that cost be less as opposed to someone who needs a lot of work done?
A: The main difference between the cost of jaw implants, and I will assume you mean combined chin and jaw angle implants, is whether off-the-shelf implants can be used or whether custom ones have to be designed and made. Since you already have a decent jawline and ‘only need a little work’, I will assume standard chin and jaw angle implants can be successfully used. There are differences in these types of implants and the materials from which they are made and this also affects cost. But I will make the assumption that silicone chin and jaw angle implants can be used. Using those inmplants, the total cost of chin and jaw angle augmentation would be around $ 6500.
Dr. Barry Eppley
Q: Dr. Eppley, First off just to inform you that I have been dealing with this since I was 19 yrs old, I am 46 yeras old now. I was born with a very weak chin. I never told anyone and always wondered why I took horrible pictures. Took me many years to figure it out that my jaw was not there. Been ripped off as one doc did needles in my neck and liposuction in 1991 and still had a turkey neck. Then I had a chin implant in 1996 and still had a turkeyneck after. I am a police officer and when people want a pic with a police officer I turn them down. I hate this. Is there any help? I do weight train & cardio but nothing changes my neck. I just entered on the computer about weak jaw for men and your site came up.
A: Thank you for your inquiry and sharing your very personal story. Until I see some pictures of you it is hard to know whether you have a very underdeveloped lower jaw although your description sounds very much like that is so since you have had this issue since you were very young. Your prior chin implant may not have been successful because the volumetric dimensions that it added were way inadequate, not that the concept of it was wrong. Significantly lengthening of the jawline and chin will also provide improvement in the turkeyneck appearance as the jawline becomes longer, a neck angle becomes more apparent. Please send me a front and side view of your face for my further assessment.
Dr. Barry Eppley
Q: Dr. Eppley, I am a 25 year old man with a normal mandible angles but a slightly weak chin that has a little steeper angle then the rest of my jaw. Anyway I have been considering a square wrap-around or extend chin implant to slightly increase the width and moderately increase the forward projection of my chin But I am concerned that a chin implant will make my jaw angles appear greater so I was thinking a combination of a chin implant with jaw angles might be right for me. So my question is generally speaking do you think that those people who undergo chin augmentation would benefit from jaw angle implants that increase the vertical height of the ramus decreasing the angle.(for me I think part of the reason my angles seem so square is because my chin is undersized and the angle is about 90 degrees but then after the groove increases to about normal dimensions) And then my second question do you have an photos that demonstrate the depression that is formed when off the shelf chin and jaw angle implants are used together?
A: There are no general statement that can be made about the influence of the chin on the appearance of the jaw angles. Each patient’s jawline and facial anatomy is unique and must be considered individually. The best way to answer your question is through computer imaging…change the chin without the jaw angles and see what it looks like. That is the best way to answer that question. You are correct in assuming that most standard chin and jaw angle implants do not meet in the ‘middle’ (body of the mandible) and, even if they do, these are thinnest and most tapered aspects of the two implants. Thus it is possible the jawline might not be perfectly straight from the chin back to the jaw angles and usually isn’t. But whether that occurs or not and is aesthetically significant depends on each patient’s jawline anatomy and the implants used.
Dr. Barry Eppley
Q: Dr. Eppley, I want to improve the look of my jawline and my lips. I am enclosing a youtube link to a male model whose lips and jawline seem to match the look I see for myself. If you have a chance to review model Chad White’s lower face and let me know if that is possible for me based upon your imaging my photo, I would be interested to hear your thoughts. I understand that the end results won’t be an exact replica, but how closely can his lower features be matched.
A: I have taken a look at the video link and you are just one of many who have sent me Chad White’s images as their desired goal. While I think having a defined aesthetic goal is always good, it usually sets up unrealistic expectations. You nor anyone can look like he does. You can only become a better you working with the anatomy you have to get a more defined jawline and larger lips. Will your jawline and lips be better with surgery…yes. Will they look like Chad White’s….no. You and he are quite different ages with different tissues and different faces. That may sound negative but I have yet to have a male patient who comes in with model photos to ever really achieve the look they ideally want. Using them to illustrate a point is one thing, but having them as the aesthetic target is not realistic. Using model pictures in my extensive experience is often a red flag for what will come after surgery…disappointment and subsequent (and sometimes endless) revisions of the procedure.
It is more important to focus on what can be done with your face and its anatomy rather than a model’s whose face you can never become.
Dr. Barry Eppley
Q: Dr. Eppley, thank you for doing the imaging. Regarding my chin and jaw I had something different in mind, I wanted something more defined and v- shaped for my jawline. Some implant that would probably wrap around my whole jaw and give me a more defined look. I’ve attached a picture of Matt Bomer to illustrate what I exactly have in mind and please tell me if I’m being realistic or not. If getting such a structure is a bigger job and you feel that a custom implant is more suitable, I’m more than fine with that. Too be honest doctor, I want to have everything perfect even its going to cost me more. Regarding the cheek bones? Do think augmentation is suitable for me or not?
A: The purpose of computer imaging is to transition the talking to a visual interpretation. It is a starting point for refining goals. What you have seen and do not like is what off-the-shelf chin and jaw angle implants do. They are fine for many patients but will not give a smooth jawline connection between the two. Only a custom wrap-around jawline design can do that.
I think using the picture of Matt Bomer is helping to define your objectives but you can never have his exact jawline because his facial tissues are thinner (less fat). Therefore, his jawbone anatomy is very well revealed including the angular flare. Your facial tissues are a bit thicker so you can end up somewhere between where you are now and his look.
In regards to the cheeks, I think they would also be helpful in achieving your desired facial look. I have done additional imaging based on these concepts.
Dr. Barry Eppley
Q: Dr. Eppley, I don’t like the shape of my jawline as it goes from front to back. I would like the front of the jaw profile to be less angular and also look deeper. I think this would improve my face shape and make it look more symmetric. I have attached a few pictures. What type of operation do I need to make this improvement?
A: I am not sure I understand what you mean by the desire to have the ‘jaw front profile less angular and also deeper’. I would need a better explanation to be sure what you see. But looking at your pictures, I think you mean that the chin is pointy (rather than square) and the jawline from the chin angles back sharply as opposed to being more square and vertically longer. The angular chin/jaw line is more associated with females while the square and broader chin is associated with a stronger male look. This could be improved by geniomandibular groove implants that fit on the bottom of the chin and go back to the anterior body of the mandible. They can be used to widen the chin as well as provide structure at the turn of the chin into the jawline so that there is a stronger jawline appearance. This is done through a submental incision and the two implant halfs are assembled into a unified implant with screws once into place. How close or separated they are in the midline affects how much the chin width is increased.
Dr. Barry Eppley
Q: I’m very interested in chin and jawline enhancement, particularly the solid one piece custom made framework. I have very little time off these days due to the economy so time off and downtime is of great concern for me. I loved the before and after pictures and would be ecstatic to get rid of my beard which I have worn since I was 19. I have had several other surgeries with great success and am very pleased with their outcome. I look forward to hearing from you.
A: Thank you for your inquiry. There are numerous types of preformed and custom jawline implants, depending upon one’s lower jaw and neck anatomy. Most are three-piece assembled units (extended chin and jaw angles) as opposed to a single-piece unit. The only one-piece unit is when only vertical elongation of the mandible/chin is being done which is the least common.
Whether one can be augmented with available preformed implants or requires a custom approach depends on what one wants to achieve as it relates to the jawline. I would need to see some pictures of you and do some computer imaging of the options to see the differences between a preformed vs a custom approach. The basic difference is that custom jaw implants offer increased augmentation sizes and can create a smooth straightline jawline from the chin back to the jaw angle. There has to be a compelling reason to use the custom approach as it requires a CT scan from which a model and the implants are made and thus costs more.
Whether preformed or custom jaw implants are used, the recovery is no different. While there are few physical limitations afterwards (other than some temporary restricted oral opening), there is considerable facial swelling which takes up to three weeks until it largely passes.
Dr. Barry Eppley
Q: I have a weak jawline and would like to do something about it. I have previously had a chin implant but it did not appear to have made much of a difference. The implant didn’t address my weak jawline. I would like to find out more about the wrap around jaw implant. How many days do I have to wait between 3D CT scan and the actual surgery? I have attached a side view picture of myswlf for you to see what I mean.
A: Thank you for sending your picture. Based on this one view, I am seeing the need for chin augmentation and possible jaw angle imlants. But it is not clear to me why a custom-made implant would be necessary. Such wrap around implants are most beneficial when the entire jawline needs to be augmented from one angle to the other It is especially useful when the entire jawline is vertically deficient for which there is no off-the-shelf implants available. Horizontal or minor vertical jaw angle deficiences can be managed by non-custom made implants. I would be curious to know why has interested you in the custom wrap-around jaw implant. Perhaps it is because you have had no success with a chin implant already. But that may be because the size and style of implant chosen was too small. I would need to know what type and size of chin implant was used to determine whether to go with a stock or custom implant for better correction.
To answer your other question, the usual turn around time from the patient getting a 3-D CT scan and then the jawline implant being ready for surgery is about 6 weeks.
Dr. Barry Eppley
Q: I am interested in getting a complete mandibular implant and would like to know an approximate cost.
A: When people use the term, complete mandibular implant, their objective is to enhance along their jawline from the angles to the chin. To achieve that look, there are two different approaches. These different methods affect how the procedure is done and the cost. The first approach, and the most common, is to use three separate implants. This includes off-the-shelf chin and jaw angle implants placed through a submental and intraoral incisions. That total cost averages around $8500 to $9500. The other approach is a custom one-piece implant that is made off of a 3-D CT scan taken from the patient. It may or may not be put in as a one-piece implant but it is completely customized to the patient’s jaw anatomy and aesthetic desires. That total cost is in the range of about $15,000.
Dr. Barry Eppley
Q: Hello Dr. Eppley, I am interested in having a stronger structured jawline. I have been wanting this and am now prepared to have this done. I am tired of seeing a round fat face and with your expertise I think I can get the sculpted jawine that I have always desired. Here are some pics of myself and pics of jawlines that I want to look like. I think my jawline needs to be built up with a chin and jaw angle implants. Let me know what you think.
A:Thank you for sending your pictures. I have reviewed them and done some realistic computer imaging. My comments are as follows:
1) A big reality check is needed here. You can not get to or look like any of those examples. You have a completely different anatomy and skin and fat thickness of your face. While an admirable goal, it is not realistic. You can be improved and maybe end up about halfway between where you are now and those examples. All I can do is take what you have and make it more defined as much as possible.
2) A square chin implant will help the front of the jaw. Your chin needs to come forward and down to become the leading point of your face.
3) You need aggressive neck and side of the face liposuction with removal of your buccal fat pads. As much facial defatting needs to be done as possible.
4) I do not think that jaw angle implants will help you. You don’t need a wide lower jaw in the back. It is plenty wide, you need better definition of what you already have. Jaw angle implants will just make your face look fatter with no better definition.
Dr. Barry Eppley
Q: I hope you can help answer some questions about chin/jaw implants please? I have a weak jaw line in that my bottom jaw is slightly further back than that of my front, if you follow. I was wondering if I would be a candidate for a chin/jaw implant and if you believe this would assist in aligning my jaw whilst avoiding a lower jaw construction which I would rather not go through?
A: Small horizontal chin deficiencies are usually the result of lack of bone growth in the chin area only. (symphysis) More significant chin deficiencies, however, are a problem with the growth of the entire lower jaw (condyle, ramus and body), meaning that the whole jaw is short not just the chin. This can be clearly evident by how one’s teeth comes together. In a jaw deficiency, the lower teeth are offset behind the upper teeth by a 1/2 to full tooth. (known as a Class II malocclusion) Chin augmentation, whether done by an implant or cutting just the chin bone, improves the projection of the chin and the facial profile but does not align the entire lower jaw.
Aligning the lower jaw, by bringing the entire jaw forward that contains the teeth, provides chin enhancement but also improves one’s bite (occlusion) as well. This is most commonly done by a sagittal split osteotomy of the lower jaw which is performed in the ramus of the mandible. It is clear to see that jaw alignment and chin augmentation are the not the same thing. Jaw alignment by bone advancement will simultaneously give chin augmentation but chin augmentation alone will not create a lower jaw alignment.
Dr. Barry Eppley
Q: I’m a 62 year old female interested in widening a narrow face with a chin/jaw widening implant that would also help with jaw lifting and mild jowls. Is this possible for someone my age?
A: It is unusual for a female at any age to desire a wider lower face. This is almost always a male procedure for the obvious reason of making the jaw line more prominent to create a masculinizing effect. It would be particularly rare, and the first time in my Indianapolis plastic surgery experience, to have an older woman make that request.
I suspect that the real reason for this request is to help improve the classic signs of facial aging which is that of jowling, loss of the jaw line, and neck sagging. While it is true that jaw line enhancement at the chin and even more posteriorly at the jaw angles can help fill out a lower face, I question whether the effect would be significant enough to achieve your goals.
While I will have to see your pictures, it is possible that chin and jaw widening in combination with a limited or tuck-up facelift may create a more ideal result. Widening and lifting along the jaw line is a diametric movement of soft tissues that will usually result in a better outcome than either procedure done alone.
Dr. Barry Eppley
Q : I have a weak chin that has bothered me my whole life. I am so self-conscious that I turn away so people can not see me in profile. I also think my entire jawline is weak, it overall looks too small for the rest of my face. Can my jawline be improved with different types of implants?
A: Historically, most people think of jaw enhancement as that of the chin only. Chin implants have been around for over fifty years and have evolved today to include a wide variety of different chin styles and sizes. For horizontal jaw shortness, a chin implant can provide a simple, quick and permanent method of significant profile improvement.
Today, jaw enhancement has progressed to consider changes along the entire jawline from back to front. Besides chin implants, the use of implants to accentuate the jaw angle have become popular. Designed to increase the width of the jaw (and some designs will lower the jaw angle as well), they increase bigonial width and create a stronger and more masculine.
Chin implants are most commonly done as a stand alone facial augmentation procedure. Jaw angle implants can also be done by themselves if an adequately projecting chin already exists. For cases of an overall weak lower jaw, the combination of chin and jaw angle implants together can make for a more dramatic change in jawline appearance. This combination (the ‘jawline trifecta’) is increasingly popular for those men who have a congenitally shorter jaw or for those want to make a stronger jawline out of an otherwise normal sized one.
Dr. Barry Eppley