What Is The Best Way To Treat My Lack Of Mandible Width And Asymmetry To My Lower Jaw?

Q: Dr. Eppley, I’m hoping you can get back to me. Essentially my main issue is the lack of mandible width and asymmetry in my lower jaw. There is absolutely no definition and I have a long, narrow face. The other problem is that one side is a lot “worse” than the other, it’s as if my jawline goes into my neck. When I look around I don’t see anyone else with this issue.

I’d like to explore the use of filler or implants to add a considerable amount of width to make the jawline more “square”. (I’m not saying I want or need to achieve a supermodel look, I’d just like more width on both sides), and to also add “definition” and to “sharpen” the mandibular angle on the side/profile view (In other words… Make it actually visible). 

Can you tell me why exactly I look this way? Is it due to the shape of the mandible/the way it grew? A lack of fat/tissue? Both? 

The chin is also somewhat weak, and slightly more “recessed” on that same side mentioned, so I would consider the use of filler here as well (if I went that route) 

My concerns are that: 

1) I’m not sure if what I want to achieve is realistically possible with dermal filler (I know other options exist… Like implants) 

2) If it is possible, then roughly how much would be needed? 

3) Would it need to be injected along the entire “edge” of the mandible? Or can it be concentrated in one area to achieve the desired result? 

I think that is all I have for now. If there’s any other information or things to note that the doc can tell me, I would love to hear it. 

If you need any other pictures please let me know. 

Thank you for listening to, and reviewing my case.

A: Thank you for your inquiry and sending your pictures. What you have is a high mandibular plane angle deformity due to significant and asymmetric ramus development. This is not a jaw deformity you can treat very effectively by injectable fillers as the volume to do so is so high that it is cost prohibitive for most people and certainly not a long term solution. The best treatment is probably a sliding genioplasty combined with custom jaw angle implants. This provides good chin augmentation and also the needed jaw angle vertical length and width that is missing.

But first a 3D CT scan is needed to fully see the shape of your lower jaw. That visual information is invaluable in treatment planning.

Dr. Barry Eppley

Indianapolis, Indiana