What Can I Do With A Custom Jawline Implant Thatr Leaves My Face Too Wide and Boxy?

Q: Dr. Eppley, I am writing to you because I am currently facing a very distressing situation with my facial structure, and I deeply hope that your expertise can help me find a solution. Right now, I have a custom wrap-around jawline implant in place. Unfortunately, it leaves my lower face looking far too wide and poorly shaped, which has become a significant emotional burden for me. Additionally, during the implant surgery, a buccal fat removal (bichectomy) was also performed. Since then, I have been dealing with a severe aesthetic issue when I smile or laugh: my “apple cheeks” bunch up aggressively and project forward in a very unnatural, isolated way. The tissue simply does not distribute smoothly or laterally anymore. My goal is to achieve a much narrower, leaner, and more naturally chiseled facial shape. I would love to schedule a virtual consultation with you to discuss how we can correct the implant’s shape and restore a harmonious, flat transition to my cheeks during animation. I would be incredibly grateful if you could help me.Thank you so much for your time and compassion.

A: Thank you for your inquiry and sending your pictures. While I have not seen your custom jawline implant design file it is obvious is that the jaw angles were vertically lengthened and extended posteriorly which is well known to have adverse aesthetic effects. For whatever reason, many surgeons and designers believe that creating a more distinct jaw angle appearance requires this type of structural change, which is rarely successful unless that is exactly the look the patient is seeking. That type of jawline change is a far cry from what I assume to be in the last picture you sent at your ideal goal. I can also see externally that there is a symmetry of the jaw angle implant placements. This is correctable by new jawline implant design that is more appropriately done for your objectives. Hopefully in creating this type of abnormal jaw angle change the masseter muscles have not been dehisced in so doing.

From a facial defining standpoint, you were never a good candidate for buccal lipectomies as this was not the source for creating a more defined face in you . You simply weren’t full in these areas. You would’ve been better off had you had perioral/lateral facial liposuction which treats the area beneath the buccal region and is more consistent with your aesthetic objectives although that degree of indentation seen in your ideal imaged picture would never be achievable to that degree.

The contour complication that you now have from the buccal lipectomy can only be treated by fan injections in an effort to restore some contour and support to the skin.

Dr. Barry Eppley

Plastic Surgeon