Can My Jawline Be Restored After V Line Surgery?

Q: Dr. Eppley, I wanted to inquire about what I could realistically achieve when I commit to a full jawline implant and 2 cheek implants. I would like to restore what I had but wanted to see if it was possible without adding much vertical length. I feel that on the side that I liked the most they mostly took the jaw angle and the thickness of the bone. I wanted to attach pictures to have you run by Dr. Eppley to see if this is achievable. Additionally would it be better to have my zygoma knocked back to the original position and have standard cheek implants put in or will custom be better for adding width and projection back to my cheekbones instead of just forward projection. I am attaching the photos below. These are all before my jaw surgery in Korea. The first is what I had before and the second is the width from the side I liked.

Thanks for all your help!

A:In looking at your panorex xrays before and afters, which provide the best information we have as to what was actually removed in your V line surgery (3D CT scans are best), it can be seen that it was really in the jaw angle area where most of the bones was removed vertically. (the chin was spared) When reducing jaw angle length that also reduces jaw angle width.  I see no bony reductive changes anterior to the jaw angles. Thus if the goal is jaw  restoration, but without adding any vertical length, then it would be just adding back some  width only to the jaw angles. Whether that amount of width reduction is worth a custom implant approach can certainly be debated.

For the cheeks you can’t just cut the bone and push it back out. Such cheekbone reduction osteotomies are a one way street so to speak. Cheek restoration requires an implant overlay. The debate there is whether standard or custom implants can do so better or more effectively.

While it is always hard to argue that custom implants are always better for any form of facial bone restoration that always depends on how much bone augmentation is needed, whether any significant asymmetry exists and what the patient prefers.

Dr. Barry Eppley

World-Renowned Plastic Surgeon