Jaw augmentation: fillers or implants? I want to have a bigger jaw.

Question

Hello doctors! I want to have a bigger jaw (larger + more define) so my face is more balance (i have naturally prominent cheekbones). I already had a chin implant (silicone not medpor) and it really helped. I was wondering if it would be better to have jaw implants; silicone or medpore? or fillers; hyaluronic acid or radiesse or permanent fillers? Thank you very much for your insightful advices!

Melvin Elson, MD · Answer

Since you have had a chin implant the jaw should be tapered toward the chin to make it even and appealing. there are many options you should discuss with your surgeon from implants to fillers but i urge you to avoid any permanent filler

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheeks, chin, lips), liposuction and/or facelifts for over 30 years.  Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  Non smiling photos of your face from the front and side would help in the evaluation.  
  Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.
Conversely, in women, the back portion of the jaw line can be augmented, with precise placement of a dermal filler, without masculinizing the jaw line or face. Fat is unreliable and not a suitable method of shaping the face (cheeks, chin, jaw line or lips).  I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Gerald Wittenberg, MSc, DMD (retired) · Answer

It is important to 'blend' the chin projection and width into the jawline extending towards the ear. Jawline implant material can be placed to balance that area and is very successful. (see website). The material selection does matter since it is best to be able to customize the material at surgery to obtain the most artistic result. The jawline must also consider the cheekbone/midface contours to look natural

Jaw augmentation: fillers or implants? I want to have a bigger jaw.

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Jaw augmentation: fillers or implants? I want to have a bigger jaw.

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