Will A Custom Jawline Implant Help Restore My Face After Jawline Reshaping Surgery?
Q: Dr. Eppley, I’m really pleased to know a chin implant can be a solution after my chin and jaw angle reduction surgery which has left my face deformed. I’ve sent pics to show how my chin dips in side profile and how the chin area directly below my lower lip protrudes when I smile. I think this is related to mentalis suspension? Really want to get rid of this protrusion, not normal looking.
- Can vertical chin implant get rid of this protrusion under my lower lip?
- Does a “mentalis resuspension” mean, cut along the gum line and stitch it again with a new stiching line in a different place? What does mentalis resuspension mean?
- What is the risk involved in mentalis resuspension? ( Or could it result in a worse bulge/protrusion or some other complications?) Or should I best leave it, if it’s going to risk resulting in a worse protrusion or some other complications.
- The center that did my CT scans seem to think that my jaw angles have been over cut (surgeon took too much bone off?), it was not cut straight and I have indented jaw angles? Does it look as if my jaw angles have been over cut? ( CT scan attached)
- Is it best I get a chin implant and 2 jaw angle implants? Or is it best to get a one piece implant that goes from one side of jaw angle ,across the chin, to the other side of jaw angle?
- Are there any down sides to having screws in your face bones? How many screws will it take to hold the implant(s)in place?
- I read online that a silicone jawline implant does not give good defined bone shape/anatomy, but acrylic PMMA is able to give that defined bone structure, is there truth in this ?
Thank you so much.
A: Thank you for sending your pictures of you and your 3D CT scan after your jawline narrowing or V line jaw reshaping surgery. In answer to your questions:
1) Vertical augmentation of your chin will help with the protrusion as the origin of the problem is the loss of volume from the previous chin reduction.
2) Mentalis resuspension is an intraoral technique where the mentalis muscle is repositioned higher on the bone.
3) The only downside with mentalis muscle resuspension is in how well it works. It has no other downsides and will not make what you have now worse. I do not think, however, that mentalis resuspension is needed for tour chin problem and implant augmentation alone is a better approach.
4) Your jaw angles do look over cut with a severe 45 degree angle to them. That matches with how you loo on the outside of your face. (the indentations over the angles)
5) Unless you want the side of the jawline augmented (which I do not think you do as there is a reason you had the original surgery…a narrower jawline), I would go with a three piece chin and jaw angle implant approach. They need to be custom made and I would design them as a single attached jawline implant (because it will cost you less to do so) but in surgery I will convert it to three pieces.
6) There are no downsides to have small 1.5mm screws in your jawline for fixation of the implants. They are roughly the size of the screws used in eye glasses.
7) A custom jawline implant, made of silicone, creates the best jawline definition and shape over any other material. PMMA would be the worst material to use since you have to shape it during surgery and achieve any symmetry and good shape between the two sides of the jawline would and be virtually impossible. Anyone who would say so otherwise is inexperienced and ill informed and does not have a contemporary understanding of facial implant materials and how to design and place them.
Dr. Barry Eppley