Q: Dr. Eppley, I am inquiring about a possible male jawline augmentation procedure and how it might fit into my existing plans. I have been using Radiesse under my eyes regularly since 2010. My last procedure was November 2013 – and I have purposely foregone any additional procedure to pursue something more. As well as building the cheekbone area solidly with filler in the upper portion of my face, my primary objective is to “etch out” a defined masculine jawline. There is also some laxity in the jowls and neck area to be resolved. I consulted with a plastic surgeon where I live and his approach is laser-assisted surgery combined with Acculift to remove and sculpt the excess fatty tissue in the lower face, jowl, and neck areas as well as enhanced with Sculptra in the lower jaw and Radiesse or Voluma to heighten cheekbones. This may still be a viable option. But I question if this will result in the “look” I am speaking of – or if, in your opinion, a jaw implant is a better way to go.
I have attached comparative photos of male models illustrating jawline and facial balance. Obviously, this is a much younger crowd – but the “look” I speak of is clear. Most particularly – and this is important – the “notch” etched diagonally between the ear and chin. I mention this because in the implant photos I have seen online, the jawline itself is improved – but this defined “etch” between cheekbone and jaw is seriously absent. And in all seriousness, it is this etch I am hoping to acquire. I would very much appreciate, Dr. Eppley, your take in this and how this might be achieved.
A: Thanks for sending your pictures and provides specifics as to the jawline changes you desire. The important concept to grasp is the jawline changes you seek can only be obtained through skeletal enhancement. They are not ‘missing’ because of soft tissues excesses and loose skin. Nor will they be obtained through the diffuse effects of filler augmentation. Only a bone-based augmentation method (implants) is going to create that degree of change and create more distinct and angular features. The other benefit of jawline implant augmentation is that it will pick up any loose or sagging skin from the neck which is of one of its side benefits. This is particularly so if a custom wrap around jawline implant is used as it has an overall lifting effect through its volume. This is ideally what you need and is the most assured method of achieving the type of jawline change that you seek.
As a commentary on the ‘etched’ facial look you hope to acquire, that is a soft tissue issue as it lies in the so called trampoline area between the skeletal highlights of the cheek, chin and jaw angle. Only fat removal has any hope of making that area more of an indentation or notch. The debate can be had about where and how the fat can be removed. A stronger and more defined jawline will help in that regard but ultimately even it needs to be combined with fat removal to have any hope of achieving that look.
Dr. Barry Eppley