JAW IMPLANTS

The jaw has three components:

• the back of the jaw (where the ramus, or vertical portion of the jaw, meets the mandible to form the gonial angle)
• the middle of the jaw (the body)
• the front of the jaw (the chin)

Chin implant surgery enhances just the front of the jaw, modifying the chin’s shape, size, and projection. It can be the go-to option when small to moderate amounts of permanent chin augmentation are needed. But it’s not suitable for everyone and can lead to less-than-ideal results. 

A jaw implant augments all three components of the jaw, from the back through the body to the chin. 

If you’re considering jaw implant surgery, it’s essential to consult a board-certified physician—typically a plastic surgeon or an oral and maxillofacial surgeon—who has experience with both types of implants.

“Chin implants are common since they’re easily placed by many types of surgeons, and the level of expertise is not high,” says Dr. Wittenberg. It can be more difficult to find a skilled surgeon who has experience with other types of facial implant surgery, but in this case, it’s well worth taking the time to seek one out.

Suitable candidates for this cosmetic procedure have:

• An underdeveloped jaw
• The psychological makeup to tolerate the time it takes for the final definition to occur. This can entail 4–6 months of puffiness, but not gross swelling, says Dr. Wittenberg. “Patience is key, since you look in the mirror daily!”
• A willingness to follow specific aftercare instructions to prevent infection.

Pros

• Implants can create a sharper, stronger, and more defined jawline when viewed in profile and from the front. It can also help balance your facial features. 
• The implant will feel to the touch like your natural jaw.
• Unlike temporary dermal fillers, this surgical procedure provides permanent results (which are usually reversible, if you don’t like the look).
• Some types of jaw implants can be custom-made or shaped during surgery, to ensure a natural-looking result.
• The implant is placed via small incisions inside the bottom of the lower lip, so there’s no visible scars.
• The surgery can be combined with other cosmetic procedures, such as rhinoplasty (a nose job), cheek implants, and liposuction to treat a double chin. It’s also not uncommon for more mature patients to combine jawline augmentation with a facelift and neck lift. Adding a jaw implant can improve bone support for the overlying soft tissue. 

Cons

• Bacterial count in the mouth is significant, so infection is possible and can lead to a need for implant removal. 
• Facial contourasymmetry can occur if the implant shifts or changes position.
• A jaw implant cannot change your bite. If you have a small jaw and an overbite, you may need orthodontia and corrective jaw surgery.
• The procedure is expensive and not covered by insurance.

Jaw implants are available in four alloplastic (synthetic) materials, all of which are considered safe.

• Silastic and silicone implants are available in standard sizes: small, medium, and large. They’re the least expensive type of implants and—because they usually don’t fuse to the bone or merge with tissue—can be easily inserted and removed, if revision surgery is ever needed or desired. Though they’re not personalized to the patient, they can be a good option.
• Medpor is made from medical-grade polyethylene, a type of plastic. Medpor implants can be challenging to remove, even shortly after surgical placement. In one recent review of alloplastic facial implants, porous implants were more likely than nonporous implants to increase the risk of infection. Because of this, some surgeons refuse to work with Medpor implants.
• Plastic, known as PEEK (short for polyetheretherketone), is a strong material that can be custom-manufactured to virtually any anatomical shape, based on a patient’s CT scan. Unfortunately, this approach also doesn’t allow for proper examination of the overlying soft tissue/muscle contours or modification in the OR.
• PTFE/Gore-Tex is the only material that a surgeon can customize via hand-carving during surgery. This practice is Dr. Wittenberg’s standard operating procedure. “Looking directly at the patient’s contours at the time of surgery allows me to achieve the shape and dimensions in the right areas of the jaw for that specific patient,” he says.

During your initial consultation, be sure to discuss with your prospective surgeon the type of implant they’ll use and the desired shape and size.

It may take some back and forth to figure out which implant will best deliver your desired results. But, as was the case for RealSelf member hessian, who opted for a custom wraparound implant, it will likely be worth it.

This outpatient procedure takes 1–2 hours. It’s typically performed under local anesthesia with IV sedation or general anesthesia, so you’ll need a trustworthy adult to take you home afterward.

Here’s what to expect during the procedure:

• The surgeon makes a small incision inside your mouth, where the inside of your cheek and gum meet. 
• Through this incision, they create a pocket for the implant. 
• They insert the implant in the pocket and fix it in place with titanium screws. It’s important that the implant is immobilized, because “the muscles in the area can activate and shift the material before it has a chance to integrate with the tissues,” explains Dr. Wittenberg. 
• Then they’ll close the incisions with absorbable sutures. 

Your results will be apparent immediately, but they’ll improve over the next six months as the tissues “tighten” and define the jawline more impressively, says Dr. Wittenberg.

Here’s what to expect during your recovery.

• You’ll need 4–7 days of downtime.
• You can expect significant welling and some bruising of the jawline and neck. According to Dr. Wittenberg, “It’s about two weeks to ‘OK,” with the resolution of most swelling. A chin or face strap can control swelling and help the overlying tissues adhere to the implant and bone. Your surgeon will also probably recommend that you avoid vigorous exercise during the first two weeks post-op.
• “After that, the puffiness continues in two more phases that are notable by the patient but not usually to coworkers: At two months, most patients feel good, and at 4–6 months, they feel amazing,” he says. 
• Your mouth opening will also be stiff for a few weeks, so you’ll be consuming only liquids and soft foods during this time.
• The cosmetic recovery—puffiness, but not gross swelling—takes several weeks.

The jaw implant photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Yes, jaw implant surgery results are permanent.

If you decide that you don’t like your result, it can be possible to remove the implant. Silastic and silicone implants are easier to remove than other types.

Jaw implant surgery is considered safe when it’s done by an accredited, board-certified surgeon, but it does come with risks and potential side effects.

The biggest risk during healing is infection. Jaw implants aren’t rejected, since the materials are safe, but infection during healing will necessitate the implant’s removal. A new implant can be placed once the infection resolves and the tissues recover, after about 6–8 weeks.

You’ll leave your surgeon’s office with strict aftercare instructions to avoid infection. “The post-surgical care is critical to the success of the procedure long-term,” says Dr. Wittenberg, whose post-op protocol includes:

• A short-term course of antibiotics.
• Antibacterial mouth rinse for at least three weeks.
• A non-chewing diet of soft foods and liquids for three weeks. “The intraoral incisions are not strong enough to withstand a normal diet until then, and opening up the wound would lead to infection,” Dr. Wittenberg explains.

He also recommends that patients sleep on their back during the first weeks to avoid “shearing” of the tissues against the implant. “We all like to lie on our face and side, but this may aggravate the initial healing and strain the incision site,” he says. 

Other potential side effects include:

• hematoma (blood pooling under the skin)
• nerve damage or numbness
• a poor cosmetic outcome, including a result that’s underwhelming, too dramatic, or asymmetrical.