Mandibular Implants
Mandibular implants are used to augment the angle of the jaw and increase width and jawline definition. Used in combination with a chin implant they enable a complete re-contouring of the jawline. The implants are especially favoured by men who desire a defined ‘stronger’ masculine jawline.
The mandible (jawbone) is the strongest bone of the face. The angle of the jaw (mandibular angle) is the area where the masseter muscle (muscle of mastication) is fixed.
The mandible undergoes growth and development up to early adulthood. Most concerns related to reduced jaw definition (hypoplasia) are usually noted at this point. Although the front part of the mandible gradually loses density and height with age which may affect chin projection (see text on chin implant), the angle of the jaw remains relatively constant during adult life.
A defined jawline
The chin and the mandibular angle both determine the shape of the lower part of the face. Facial length and projection is determined by the chin, facial width and angularity are determined by the position and shape of the mandibular angle.
Typically the mandibular angle is 110 degrees. If this angle becomes larger the jaw appears rounder and softer. In contrast, shorter angles will make the jaw appear more angulated.
In addition, the distance between the two mandibular angles also play an important aesthetic role, as this distance will determine the width of the lower 1/3 of the face in frontal view. The wider the distance, the more ‘square’ the appearance.
Mandibular implants
Mandibular implants are positioned at the angle of the mandibular bone, below the masseter muscle. Their anatomical shape allows them to taper naturally into the bone. The firmness and shape of the implant is conveyed through the muscle and soft-tissues to enhance jawline width and angularity. Mandibular implants are customised to fit individual needs and aesthetic preferences.
A hypoplastic (underdeveloped) mandible is associated with soft and round facial contours. A mandibular implant (blue) will enhance definition of the jawline.
Surgical technique
The implants are inserted through the inside of the mouth (intra-oral approach), leaving no visible scars. Implants are composed of either firm silicone rubber or porous high-density polyethylene. Silicone implants are used for light-moderate mandibular adjustments. They are positioned in the periosteal space (between the mandible and the thin overlying sheet of tissue). These implants are flexible, adapt to bone topography and don't require fixation. Polyethylene implants are indicated when more pronounced changes are required, they are rigid and require fixation.
Expected outcome
Mandibular implants are well-tolerated (biocompatible), designed to provide long-lasting natural-looking enhancement of the jaw. An addition of a 4 mm implant on both sides (total 8 mm) is considered a light-moderate augmentation and is sufficient to provide visible improvement. Shape additions can be as large as 10-12 mm on each side depending on requirements.
Mandibular implant surgeries are associated with few complications. Revision surgeries may relate to local infections or aesthetic re-contouring (2-5 %). Should this be required, implant removal is straightforward.
