I have flat cheekbones and a recessed maxilla. If I bring my maxilla forward, will it help my cheekbones? Or will I need a separate implant or filler?

[blueeagle4411]

I know that having flat cheekbones, recessed maxilla, and poor mandibular area are correlated. What would be the best way to fix all of these things?

 

[PubertyMaxxer]

Jaw Surgery w midaface Implants

 

[Pendejo]

Is your whole midface recessed or only the subnasal area?

 

[Selfahate]

Bring your maxilla forward wtf
How old are u

 

[blueeagle4411]

Is your whole midface recessed or only the subnasal area?

Whole midface

 

[freeone12]

bump same problem, if I think the answer is custom cheek/chinjaw implants but only surgeo doing this procedure in europe is defrancq, dont know about andreishchev...

 

[Bewusst]

my cheekbones only started showing after getting lean(er)

 

[TsarTsar444]

Stop asking these questions, we all know you won't do anything to your maxila jfl

 

[Deleted member 2933]

Stop asking these questions, we all know you won't do anything to your maxila jfl

 

[registorm]

yea i had a flat face and recessed but after hardcore mewing my maxilla went forward and i have godtier zygos+cheekbones not joking
bringing maxilla forward will make your bones immerge

 

[zq336]

The only way to do it surgically would be either a Lefort 3 or a Lefort 1 + Midface implant.

I had a similar problem as you, with a significant underbite. I had a Lefort 1 done to fix my bite, but my midface was still pretty recessed, so I had a midface implant a few years later that gave good results.

 

[GetThatBread]

If you bring it forward it’ll help but it won’t change laterally

 

[highT]

The only way to do it surgically would be either a Lefort 3 or a Lefort 1 + Midface implant.

I had a similar problem as you, with a significant underbite. I had a Lefort 1 done to fix my bite, but my midface was still pretty recessed, so I had a midface implant a few years later that gave good results.

can you describe your midface implants? were they custom designed or off the shelf? silicone? i am in similar position (i had bimax done 7 years ago- also an underbite case) and my maxilla is better now after being moved forward, but my cheekbones are still flat. i would really appreciate any advice or input you might have.

 

[zq336]

can you describe your midface implants? were they custom designed or off the shelf? silicone? i am in similar position (i had bimax done 7 years ago- also an underbite case) and my maxilla is better now after being moved forward, but my cheekbones are still flat. i would really appreciate any advice or input you might have.

Hi, I originally had standard submalar silicon implants, but since the area of my recession was so large, they didn't really give me the effect I was looking for.

So I went with custom silicon implants that gave me a more forward midface, along with some infraorbital rim height.

Looks a little bit like this:

https://exploreplasticsurgery.com/wp-content/uploads/2018/05/Custom-Midface-and-Jawline-Implant-designs-Dr-Barry-Eppley-Indianapolis.jpg

I wanted to be conservative so I didn't go too large, but it looks pretty good.

 

[highT]

Hi, I originally had standard submalar silicon implants, but since the area of my recession was so large, they didn't really give me the effect I was looking for.

So I went with custom silicon implants that gave me a more forward midface, along with some infraorbital rim height.

Looks a little bit like this:

https://exploreplasticsurgery.com/wp-content/uploads/2018/05/Custom-Midface-and-Jawline-Implant-designs-Dr-Barry-Eppley-Indianapolis.jpg

I wanted to be conservative so I didn't go too large, but it looks pretty good.

Thanks for sharing! I actually have consulted with Eppley, as he is one of the only surgeons I know
of in the USA who offers such comprehensive custom augmentation of the midface area. I’ve been hesitant about moving forward with the procedure due to the expensive cost, and the idea of having implants in my face makes me feel a bit nervous. Was your surgeon in Europe?

 

[zq336]

Thanks for sharing! I actually have consulted with Eppley, as he is one of the only surgeons I know
of in the USA who offers such comprehensive custom augmentation of the midface area. I’ve been hesitant about moving forward with the procedure due to the expensive cost, and the idea of having implants in my face makes me feel a bit nervous. Was your surgeon in Europe?

No, it was Eppley.

Yes I know, unfortunately there are not too many surgeons who offer these types of implants and have a lot of experience doing them. It is a bit pricey, but at least with a custom design you can choose the exact shape and size you want. Why are you nervous about implants?

 

[bonesoverblood]

I know that having flat cheekbones, recessed maxilla, and poor mandibular area are correlated. What would be the best way to fix all of these things?

Expansion of the palate.

If you are younger than 17 mew.

Older, get surgery.

 

[highT]

No, it was Eppley.

Yes I know, unfortunately there are not too many surgeons who offer these types of implants and have a lot of experience doing them. It is a bit pricey, but at least with a custom design you can choose the exact shape and size you want. Why are you nervous about implants?

The main thing that makes me nervous is the possible long-term side effects of the implant such as possible displacement or ‘bone erosion.’ For example, I am a side sleeper and I wonder if years of pressure/movement of my head against the pillow would eventually shift the implant and cause some sort of issue. And then, what if this occurred after Eppley was retired and I had to seek out a different doctor for removal? That sort of situation scares me, but I also don’t know if I’m being overly paranoid and unreasonably worried. Theoretically with the screw fixation these implants would be held in place permanently. The fact that they would be so close to my eyes is also partially what makes me nervous. The eyes are so important and so fragile.

Again, very interested in your opinion on these thoughts and your experience thus far. I’ve read testimonials of a woman who has had malar cheek implants for 30 years with absolutely zero issues and zero regrets. I think I have a tendency to visualize the “worst case scenario” and scare myself.

 

[zq336]

The main thing that makes me nervous is the possible long-term side effects of the implant such as possible displacement or ‘bone erosion.’ For example, I am a side sleeper and I wonder if years of pressure/movement of my head against the pillow would eventually shift the implant and cause some sort of issue. And then, what if this occurred after Eppley was retired and I had to seek out a different doctor for removal? That sort of situation scares me, but I also don’t know if I’m being overly paranoid and unreasonably worried. Theoretically with the screw fixation these implants would be held in place permanently. The fact that they would be so close to my eyes is also partially what makes me nervous. The eyes are so important and so fragile.

Again, very interested in your opinion on these thoughts and your experience thus far. I’ve read testimonials of a woman who has had malar cheek implants for 30 years with absolutely zero issues and zero regrets. I think I have a tendency to visualize the “worst case scenario” and scare myself.

From what I understand bone erosion is something that mainly happens in the chin due to the larger pressures, and only results in at most ~2 mm of bone loss and then stops. Most people have less than 1 mm erosion. In other areas of the face the effect is negligible.

Here's something Dr. Eppley had wrote:

Biologic Tissue Reactions around Jaw Angle Implants - Explore Plastic Surgery

Jaw angle implants can cause benign bony changes of implant settling and some limited bone overgrowth.

exploreplasticsurgery.com

I think him and others have written other articles about this issue, but the conclusion was that it's a non-issue.

I'm also a side sleeper and I haven't noticed anything, if I push on the implant I don't think I could move it if I tried. I've had implants for the last 6 years and have not had any issues.

Would you want any elevation of the infraorbital rim? If not, then the implant can be placed through the mouth. If you do, then the incision would have to be made under the lower eyelid, which carries a small risk of eyelid retraction.

 

[highT]

From what I understand bone erosion is something that mainly happens in the chin due to the larger pressures, and only results in at most ~2 mm of bone loss and then stops. Most people have less than 1 mm erosion. In other areas of the face the effect is negligible.

Here's something Dr. Eppley had wrote:

Biologic Tissue Reactions around Jaw Angle Implants - Explore Plastic Surgery

Jaw angle implants can cause benign bony changes of implant settling and some limited bone overgrowth.

exploreplasticsurgery.com

I think him and others have written other articles about this issue, but the conclusion was that it's a non-issue.

I'm also a side sleeper and I haven't noticed anything, if I push on the implant I don't think I could move it if I tried. I've had implants for the last 6 years and have not had any issues.

Would you want any elevation of the infraorbital rim? If not, then the implant can be placed through the mouth. If you do, then the incision would have to be made under the lower eyelid, which carries a small risk of eyelid retraction.

Thanks for the info I will check out that article you shared. Very reassuring to hear your experience has been good and 6 years is a long time! I would also be wanting some elevation of the orbital rim for my case. Eppley told me he would perform a minor canthopexy (I believe that was the term he used) to tighten the eyelids in a preventative measure against retraction. That’s another thing I worry about because I definitely would want vertical augmentation to the rim. Did you have the eyelid incision method?

 

[Deleted member 1707]

Start mewing ASAP or rope

 

[zq336]

Thanks for the info I will check out that article you shared. Very reassuring to hear your experience has been good and 6 years is a long time! I would also be wanting some elevation of the orbital rim for my case. Eppley told me he would perform a minor canthopexy (I believe that was the term he used) to tighten the eyelids in a preventative measure against retraction. That’s another thing I worry about because I definitely would want vertical augmentation to the rim. Did you have the eyelid incision method?

Yes I did. Yeah retraction is rare, but it's a risk. On the plus side, going through the eyelid greatly reduces the risk of infection (Eppley told me he had never seen a case).

 

[highT]

Yes I did. Yeah retraction is rare, but it's a risk. On the plus side, going through the eyelid greatly reduces the risk of infection (Eppley told me he had never seen a case).

Thank you again so much for sharing your experience and knowledge with me, it is incredibly valued. I am curious if you remember, do you recall how many millimeters of augmentation you chose per side? Vertical rim elevation, forward projection, possibly even zygomatic arches projecting laterally to increase the width of the midface from a frontal view? If you still had the 3d implant design images and could PM me I would love to see what you went with so that I could have a better idea of how to design my own in the near future.

 

[Slayerino]

Whole midface

Then FP be it

 

[Pietrosiek]

flat zygos are better than prominent low set round zygos

 

[zq336]

Thank you again so much for sharing your experience and knowledge with me, it is incredibly valued. I am curious if you remember, do you recall how many millimeters of augmentation you chose per side? Vertical rim elevation, forward projection, possibly even zygomatic arches projecting laterally to increase the width of the midface from a frontal view? If you still had the 3d implant design images and could PM me I would love to see what you went with so that I could have a better idea of how to design my own in the near future.

Mine was 5 mm rim elevation, around 7 mm forward projection, and around 4 mm along the zygomatic arches. If you do decide to get it I can PM you later.

I would warn you that everyone is different, my recession was quite significant so I required a fairly large implant (and it probably could have been a little bit bigger), but this size on most people would look way overdone. I think most cheek implants do not exceed around 3-5 mm in thickness at any point.

 

[highT]

Mine was 5 mm rim elevation, around 7 mm forward projection, and around 4 mm along the zygomatic arches. If you do decide to get it I can PM you later.

I would warn you that everyone is different, my recession was quite significant so I required a fairly large implant (and it probably could have been a little bit bigger), but this size on most people would look way overdone. I think most cheek implants do not exceed around 3-5 mm in thickness at any point.

Thanks for sharing these numbers, very helpful, especially because I think I probably have a similar starting point as you, based on the fact that I also had a lefort 1 to correct an underbite that was simply one part of my total midface recession. Last step for me now is addressing the cheekbone/infraorbital rim area. On the bright side, I’m sure the recovery is going to be a breeze compared to the lefort 1 I had done years ago. I’m glad that you have had such a pleasant outcome! I imagine it must feel so much better after correcting a deficiency, the confidence boost etc.

 

[MogTheMogger]

BIMAX + Lefort 3 + BSSO

 

[reptiles]

BIMAX + Lefort 3 + BSSO

Only manipulates schlanocranium unforantely we need a ccw for the cranial base

 

[MogTheMogger]

Only manipulates schlanocranium unforantely we need a ccw for the cranial base

wdym, explain to me how, if the bimax 3 manipulates the splanchnocranium?

 

[Cope]

MSE + FP and then depending on that see if you still need custom infraorbital-malar implants to attain the high cheekbone look.