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Custom Chin Implants

Custom chin implants are useful when significant vertical elongation of the chin is needed, the implant extension needs to go back further along the jawline than conventional chin implants will allow or there is some significant chin asymmetry. The key surgical point about their placement is the consideration of the placement of the incision when done from a submental approach. The incision may need to be further back than the submental crease as the tissue recruitment from the implant may ‘roll out’ the submental tissues further than one would think of the custom chin implant adds any significant vertical length.

Custom chin implant design for make who desires a square chin with slight vertical elongation.
Custom chin implant design for female who desires to have a modest amount of horizontal and vertical chin augmentation without widening the chin.
Small petite chin implant for female who is also having multiple other custom facial implants done.
Male who wanted a strong wide square chin implant design.
Female with significant chin shortness with class II maocclusion hat needed a large amount of horizontal advancement with needed to keep the chin narrow.
Total male three-piece jawline augmentation with custom square chin and jaw angle implants designs.
Custom chin implant design for female with prior sliding genioplasty to add additional chin projection and to smooth out bone irregularities along the jawline.
Custom cleft chin implant design for male three-piece total jawline augmentation.
Petite custom female chin implant design with an upward tilt to the horizontal projection.
Custom lateral chin implant design for fill in lateral bone defects from prior sliding genioplasty.
Extended square chin and jawline implant design for vertical jawline lengthening in a male.
Female who previously had an anatomic chin implant placed to try and achieve a V-shaped chin appearance…which was unsuccessful. A custom V-shaped chin implant design was more effective.
Trying to hang a standard chin implant design off of the bone to create a V-shape is fraught with potential implant malpositioning issues as that is not what they are made to do. Unique chin reshaping needs require a custom chin implant approach to be more effective.
One often leans from the first chin implant what look they may want better. In this case a male with a standard round extended anatomic chin implant that subsequently desired a more square shape with wings that more assuredly sat lower along the lower edge of the bone.
When design square chin implants for men the shape must be over exaggerated a bit because the thickness of the soft tissue chin pad will obscure some of the detail of the implant design.
The optimal square chin look for men requires a chin implant design that takes the squareness out to the canines and adds a little vertical length to help stretch out the soft tissue chin pad.

Custom Jaw Angle Implants

Bony jaw angle/jaw angle implant asymmetry and the desire for vertical elongation of the jaw angles are two most common indications for custom jaw angle implants. Asymmetric placement of jaw angle implants is very common and is caused by both placement error and slight but significant differences in natural jaw angle shapes. A little difference in the shape or angular form of the jaw angles can translate into a very visible difference when they are enlarged by implants. Aesthetic augmentation of jaw angles often requires vertical lengthening (dropping down) of the jaw angles which no current form of jaw angle implant provides. While jaw angles are often perceived as just being made wider, the more common aesthetic need for many jaw angle augmentations is create by lowering the jaw angle and not by just making it wider. In some cases this requires the entire jawline from angle to angle to be made vertically longer.

Custom jaw angle implant designs to fill in bony defects and smooth out the jawline after orthognathic surgery. (sagittal split ramus osteotomies of lower jaw)
Custom jaw angle implants designs for back of jaw augmentation after prior sagittal split ramus osteotomies.
Custom jawline implant designs to go with a sliding genioplasty for overall jawline augmentation in a female. (who also had a large custom skull implant done at the same time)
Custom jaw angles implants design to go with a vertical chin reduction intraoral osteotomy.
Custom jaw angle implant designs for a male after V-line reduction sur-gery to restore some of the lost jaw angles.
Male total jawline augmentation with custom extended jaw angle im-plants to vertical and horizontally lengthening sliding genioplasty.
Custom jaw angle implant designs to balance out jawline shape after or-thognathic surgery in a male.
Custom flared jaw angle implants to complete a total jawline augmenta-tion effect after a sliding genioplasty.
Custom jaw angle implant designs to create a more complete male jaw-line effect after a prior sliding genioplasty.
Custom jaw angle implant designs in facial asymmetry with custom left cheek implant as well.
Small custom left jaw angle implant design for correction of lower jaw asymmetry in a female.
Extended custom jaw angle implants for correction of the high mandibu-lar plane angle make patient with accentuated antegonial notches.
Custom right extended jaw angle implant for correction of lower facial asymmetry in a female.
Custom jaw angle implants made to provide a complete jawline augmentation effect in a patient who had an existing chin implant of which he was happy with its aesthetic result.
Custom right jaw angle implant to correct jaw angle asymmetry from prior sagittal split mandibular osteotomy.
Much of the jaw angle asymmetry after sagittal split mandibular osteotomies has a vertical component to it and not just a width issue. This is why standard jaw angle implants often do not work well in this type of jaw asymmetry.
The difference between the jaw angle asymmetry that occurs after a sagittal split osteotomy and how to best treat it is illustrated in this case where a standard jaw angle implant was inadequate and a custom jaw angle implant design showed the amount of bone that needed to be replaced for optimal jaw symmetry.

Custom Jawline Implants

Currently aesthetic augmentation of the jawline is a very popular use of the custom design process. While there are standard styles and sizes of both chin and jaw angles, there is no total jawline implant. A standard jawline implant would be impossible to create as a complete wrap around implant due to the variability in jawline sizes between people.

Having an implant that connects one jaw angle to the other across the chin is the most powerful method to enhance a jawline. This is of particular interest in men who want to have an overall stronger and more defined jawline. With an implant that covers a large bony surface area, it is important to not oversize it in any one dimension. With a facial implant that covers such a large surface area, it is very easy to oversize it as the influence on the jawline shape is significant.

A custom wrap around jawline implant is inserted through three separate incisions. Bilateral intraoral posterior mandibular vestibular incisions are used to position the jaw angle portion of the implants. An anterior incision, either intraoral or external submental, is used to insert the entire implant and feed it back to the jaw angles in a folded fashion.

Male custom jawline implant designed to replace standard chin and jaw angle implants which are misplaced.
Custom jawline implant designate vertically lengthen a low or flat mandibular plane angle patient.
Female custom jawline implant design which rounded narrow chin and vertical jawline lengthening.
Strong custom jawline implant and cheek implanted designs for maximal male masculinization effect.
Petite custom jaw angle implant design for a female.
Female custom jawline implant design to partially restore jawline after an overly aggressive V-line jaw reduction procedure.
Moderate custom jawline implant and cheek implanted designs for maximal male masculinization effect.
Female custom jawline implant design needed for jawline restoration after V-line jaw reduction surgery.
Custom jawline and cheek implants designs in an older male for a facial rejuvenation effect and filling out of sagging tissues.
Custom jaw angle implant design to change a low mandibular plane angle into a higher plane angle.
Custom left jawline implant combined with a right inferior border osteotomy to treat lower jaw asymmetry.
Large custom non-linear jawline implant design for strong masculinization effect.
Custom jawline implant replacement design for displaced chin and jaw angle implants.
Custom inferior border jawline implant design for lower facial vertical lengthening.
Custom jawline implant design for a smooth linear and increased augmentation effect after a chin wing osteotomy.
Custom infraorbital-malar and jawline implant designs for strong facial masculinization effect.
Male custom jawline implant to restore jawline after V-line reduction surgery.
Custom jawline and right cheek implant designs for correction of facial asymmetries.
Custom jawline implant replacement in a male for unachieved effects from strandard chin and jaw angle implants.
Custom jawline implant design for high mandibular plane angle male patient.
Custom jawline implant design to straighten out a nonlinear and add vertical length to the chin. (replace an inadequate standard chin implant).
Custom jawline and brow bone implants for facial masculinization after prior sliding genioplasty and extended chin implant failed to achieve the desired jawline augmentation effect.
Small custom jawline implant design to enhance a softer and more indistinct male jawline.
Custom jawline implant design to treat a hooked jawline and short chin.
Custom female jawline implant which typically has a smaller overall size, less jaw angle width and more narrow chin shape.
Custom jawline implants for females, while being smaller in size than for males, usually add vertical jaw angle length/shape and come forward with a smooth linear connection to the chin.
Custom jawline implants are often requested for the treatment of facial asymmetry which often involves the lower jaw. The patient will often choose to then just augment the entire jawline for an overall lower jaw augmentation as well as correction of the jaw asymmetry.
Female custom jawline implant for V Line reversal surgery.
When designing a custom jawline implant for V Line reversal surgery consideration is given to whether the patient wants a subtotal or total restoration of their removed jawline.
Attempting to partially or fully reverse a prior V line surgery can not be done very well by using any form of standard implants as illustrated in this case where strips of ePTFE (Goretex) were used. (in green) V line jaw restoration needs a smooth jawline implant that restores much of the vertical length of the jawline that was previously resected.
V line reversal surgery is largely about vertical jawline restoration, which can only reliably be done using a custom implant design approach. Patching together standard implant materials to try and create this unique jawline augmentation effect works poorly as seen with these ePTFE implants. (in green)
Many custom jawline implants start out with a chin implant as their entrance into lower facial reshaping surgery. Either due to an inadequate chin augmentation result or the desire to ‘graduate’ to a complete jawline effect, the existing chin implant serves as a helpful guide as to how to improve the chin as well as that of the rest of the jawline.
A prior chin implant that produces an undesired effect (in this case a chin that became too vertically long) ‘teaches’ one how to make it better when a custom jawline implant is designed for its replacement.
Prior chin implant issues, such as asymmetries, often lead to the consideration of not only improving the chin augmentation, but converting to a total jawline augmentation effect with a custom jawline implant approach.
Many short chins are associated with a high and indistinct jaw angles. Changing from an initial chin implant to a custom jawline implant improves then entire shape of the lower face.
In the high jaw angle or steep mandibular plane angle patient widening jaw angle implants may look acceptable from the front but they accentuate the steep mandibular plane angle from any other facial view. The combination of lowering the jaw angles and shortening the chin usually produces a better overall lower facial shape. Standard submalar implants in a male rarely produce a positive aesthetic benefit. Men usually want a high cheekbone look which can only currently be achieved by a custom cheek implant design.
Replacement of standard cheek and jaw angle implants with custom cheek and jawline implants.
Custom jawline implant design for male who wanted to achieve two simultaneous lower jaw objectives, fix the right lower jaw asymmetry and create an overall stronger lower facial appearance.
A custom jawline implant provides the most effective approach to improving the asymmetric jawline because it identifies and treats the entire jawline deficiency…which is particularly challenging when such deficiency is vertical in nature.
Injectable fillers (e.g., Radiesse which appears in the green color) is often used for jawline augmentation which resides up in the soft tissues. By comparison a custom jawline implant (in teal color) sits down on the bone below the soft tissues. As a result, injectable fillers produce a more rounded jawline effect while a bone based implant is capable of a stronger more well defined jawline look.
While injectable fillers (in green) can have a good temporary effect their soft tissue location limits the jawline definition they are capable of creating for many patients….unlike that of the custom jawline implant. (in teal color)