A line is drawn from the nasal tip to the most anterior point of the lower lip. The distance from soft
tissue pogonion to the ideal soft tissue pogonion is the amount of correction. Alloplastic augmentation
does not correct the soft tissue in a 1 : 1 ratio. In the case of a patient having normal soft tissue (8~11
mm), the ratio of the soft tissue correction is 1 : 0.66. In the case of a patient having a soft tissue
deficiency (less than 7 mm), the ratio of the soft tissue correction is 1 : 0.8. In the case of a patient
having a soft tissue excess (more than 12 mm), the ratio of the soft tissue correction is 1 : 0.5. The
length of the implant is required to be more lateral to the mental foramen by 1~1.5 cm for restoration
of the prejowl sulcus. The posterior surface of the implant must be carved to shape precisely to the
bony surface. I usually make several vertical etchings and 20~30 holes in the implant. The vertical
etchings help expand the implant to securely fit the mandibular contour. Fenestrated silastic implants
can be further stabilized with fibrous tissue ingrowth and future reconstruction if bony erosion occurs.
(Archives of Aesthetic Plastic Surgery 17: 55, 2011)