Jaw Surgery w/ Dr. Ort (former Eppley/Yaremchuk patient)

[Gigachang]

3 rhinos huh? were they botching you or did it just not end up satisfactory every time? i heard rhinos usually leave people unhappy

 

[arbiter891]

Pre-op pics for original rhinoplasty - age 28.

damn bro they scammed you on the rhino and chin implant. if you went straight for double jaw you'd been set.

 

[arbiter891]

3 rhinos huh? were they botching you or did it just not end up satisfactory every time? i heard rhinos usually leave people unhappy

his nose was never the issue

 

[arbiter891]

ngl bro looking at all ur before and afters it's crazy u still basically look like the same person lol

 

[LEFORT17]

I had a pretty active thread here four years ago about some Eppley infraorbital implants: https://looksmax.org/threads/removing-eppley-cheek-implants.378955/.

Since then, I've had bimax with Sam Bobek for sleep apnea, which had a great functional outcome but a bad aesthetic one. (Not really his fault; he had to take out a Yaremchuk jaw implant from 2016, which caused a lot of neck jowling/sagging.)

Here's my full surgery rundown:

• 2011 - rhinoplasty and chin implant - Wayne Larrabee
• 2012 - hair transplant - Robert Niedbalski
• 2013 - revision rhinoplasty - Wayne Larrabee
• 2015 - hair transplant - H. Rahal
• 2016 - custom wraparound jaw implant - Michael Yaremchuk
• 2020 - custom infraorbital implants - Barry Eppley (tried to do a replacement jaw implant, but couldn't remove Yaremchuk implant due to bone overgrowth)
• 2021 - lid retraction repair/canthoplasty/ptosis repair - A.J. Amadi (mainly to correct lower lid retraction on right side caused by lower eyelid incisions to place infraorbitals)
• 2022 - revision to size down infraorbitals via hand-carving and re-placing - Barry Eppley
• 2024 - bimax + genio for sleep apnea -Sam Bobek (including removal of Yaremchuk jaw implant)
• 2024 - additional attempt at lower lid retraction repair on right side (removal of Eppley infraorbital on right side and replacement with hand-carved ePTFE implant to provide structural support for lower lid)
• 2025 - revision rhinoplasty - Aaron Kosins
• 2025 - reduction genioplasty, jaw shaving, custom jaw angle implants, neck lift - Yirae Ort

I'm 43. Ask constructive questions and I'll give constructive answers. Before and after pics are below; I'm only 14 days PO with Ort, so there's some swelling, especially on the jawline.

View attachment 4266359View attachment 4266367

you look like ur in your early 20s damn

 

[weepmeep]

goat

 

[Hide]

he needs to fix his upper eyelid exposure, but that's risky. I get why he'd be averse to targeting it, after he had to get multiple reconstruction surgeries for the lower lids.

Fat grafting isnt thay risky tbh

 

[Corleone]

Fat grafting isnt thay risky tbh

true, but also not that effective if you want to be lean

 

[UMIRINBRAH?]

I had a pretty active thread here four years ago about some Eppley infraorbital implants: https://looksmax.org/threads/removing-eppley-cheek-implants.378955/.

Since then, I've had bimax with Sam Bobek for sleep apnea, which had a great functional outcome but a bad aesthetic one. (Not really his fault; he had to take out a Yaremchuk jaw implant from 2016, which caused a lot of neck jowling/sagging.)

Here's my full surgery rundown:

• 2011 - rhinoplasty and chin implant - Wayne Larrabee
• 2012 - hair transplant - Robert Niedbalski
• 2013 - revision rhinoplasty - Wayne Larrabee
• 2015 - hair transplant - H. Rahal
• 2016 - custom wraparound jaw implant - Michael Yaremchuk
• 2020 - custom infraorbital implants - Barry Eppley (tried to do a replacement jaw implant, but couldn't remove Yaremchuk implant due to bone overgrowth)
• 2021 - lid retraction repair/canthoplasty/ptosis repair - A.J. Amadi (mainly to correct lower lid retraction on right side caused by lower eyelid incisions to place infraorbitals)
• 2022 - revision to size down infraorbitals via hand-carving and re-placing - Barry Eppley
• 2024 - bimax + genio for sleep apnea -Sam Bobek (including removal of Yaremchuk jaw implant)
• 2024 - additional attempt at lower lid retraction repair on right side (removal of Eppley infraorbital on right side and replacement with hand-carved ePTFE implant to provide structural support for lower lid)
• 2025 - revision rhinoplasty - Aaron Kosins
• 2025 - reduction genioplasty, jaw shaving, custom jaw angle implants, neck lift - Yirae Ort

I'm 43. Ask constructive questions and I'll give constructive answers. Before and after pics are below; I'm only 14 days PO with Ort, so there's some swelling, especially on the jawline.

View attachment 4266359View attachment 4266367

nn

 

[Hide]

true, but also not that effective if you want to be lean

Supras too are very safe tbh

 

[Legit Theory]

do you have any advice on how to learn your facial flaws in order to devise a proper surgical plan? its so overwhelming

additionally you mentioned being on steroids before, yet at 43 you look very young, what is your anti aging skin care routine?

 

[Win200]

3 rhinos huh? were they botching you or did it just not end up satisfactory every time? i heard rhinos usually leave people unhappy

Never botched. Just kept settling with a deviation in the columella, so I waited several years and had Aaron Kosins rebuild it with rib cartilage. Not uncommon to have a nose that wants to heal with a pull to one side or the other.

 

[Win200]

ngl bro looking at all ur before and afters it's crazy u still basically look like the same person lol

That's the goal... you want to be a better looking version of yourself. I don't want to transform into another person. Unhealthy af to do that (or want it)

 

[Win200]

damn bro they scammed you on the rhino and chin implant. if you went straight for double jaw you'd been set.

The original nose was fucking horrible lol and would've needed to be redone no matter what. Chin implant was reasonable without knowing about the narrow airway issue (which I didn't back in 2011)

 

[Win200]

do you have any advice on how to learn your facial flaws in order to devise a proper surgical plan? its so overwhelming

additionally you mentioned being on steroids before, yet at 43 you look very young, what is your anti aging skin care routine?

Look for areas of asymmetry or lack of harmony--like a crooked nose, or a receded chin. I really wouldn't go down the obsessive route of measuring millimeters and chasing some "ideal" ratio like a lot of people here do. Figure out what bothers YOU and what YOU want to look like, then decide how invasive you're willing to go to correct it. I personally think that getting bimax for purely aesthetic reasons is really insane, but some people decide that the risk/unpredictability and process are worth it. Some procedures are a lot more reliable and consistent than others.

My advice for doing steroids is to do the lowest possible dose of test that gets you a nice body and stop there. Don't do tren, dbol, etc.--all of those compounds have a much higher risk profile, jack up your skin, wreak havoc on your hair, etc. Test doesn't age you nearly as much, has a lower side effect profile, and is all you need unless you're a pro bodybuilder. I still had nice skin on cycle because I was only running 500mg test/week. Don't get greedy.

On skincare, it's not super sophisticated. Use a good retinol a few times a week, moisturize, and use an SPF every morning. I started Botox at 27 and stayed consistent, and that helped prevent wrinkles. I still don't have any resting wrinkles at 43.

 

[Foreverbrad]

Did you never have your UEE filler dissolve then reapplied?

I am considering this for my own UEE problem and weighing against fat grafts.

 

[Win200]

Did you never have your UEE filler dissolve then reapplied?

I am considering this for my own UEE problem and weighing against fat grafts.

I haven't yet but need to. Just not many injectors I trust with UEE area, so need to fly down to LA to see someone there.

Why are you weighing against fat grafting?

 

[aids]

Miring hard OP! You hardly look 30.

 

[WAGMI2 Gandy Heaven]

is this the same surgeon that did Chestbrah's procedures since you guys share some similarities for some reason?

 

[Mr.Proper]

10 surgeries (if you don't count hair transplants), that's ridiculous. What about high eyebrows/ "surprised look"? IMO that's what brings you don't the most, the rest look good for such age.

 

[justjutting]

I started Botox at 27 and stayed consistent, and that helped prevent wrinkles. I still don't have any resting wrinkles at 43.

Do you inject botox in ur under eye area?

 

[IBlameClavicular0]

I had a pretty active thread here four years ago about some Eppley infraorbital implants: https://looksmax.org/threads/removing-eppley-cheek-implants.378955/.

Since then, I've had bimax with Sam Bobek for sleep apnea, which had a great functional outcome but a bad aesthetic one. (Not really his fault; he had to take out a Yaremchuk jaw implant from 2016, which caused a lot of neck jowling/sagging.)

Here's my full surgery rundown:

• 2011 - rhinoplasty and chin implant - Wayne Larrabee
• 2012 - hair transplant - Robert Niedbalski
• 2013 - revision rhinoplasty - Wayne Larrabee
• 2015 - hair transplant - H. Rahal
• 2016 - custom wraparound jaw implant - Michael Yaremchuk
• 2020 - custom infraorbital implants - Barry Eppley (tried to do a replacement jaw implant, but couldn't remove Yaremchuk implant due to bone overgrowth)
• 2021 - lid retraction repair/canthoplasty/ptosis repair - A.J. Amadi (mainly to correct lower lid retraction on right side caused by lower eyelid incisions to place infraorbitals)
• 2022 - revision to size down infraorbitals via hand-carving and re-placing - Barry Eppley
• 2024 - bimax + genio for sleep apnea -Sam Bobek (including removal of Yaremchuk jaw implant)
• 2024 - additional attempt at lower lid retraction repair on right side (removal of Eppley infraorbital on right side and replacement with hand-carved ePTFE implant to provide structural support for lower lid)
• 2025 - revision rhinoplasty - Aaron Kosins
• 2025 - reduction genioplasty, jaw shaving, custom jaw angle implants, neck lift - Yirae Ort

I'm 43. Ask constructive questions and I'll give constructive answers. Before and after pics are below; I'm only 14 days PO with Ort, so there's some swelling, especially on the jawline.

View attachment 4266359View attachment 4266367

How much time did it take to heal from the genioplasty?

Also, did you add some fat grafts after getting the genio?

 

[Win200]

10 surgeries (if you don't count hair transplants), that's ridiculous. What about high eyebrows/ "surprised look"? IMO that's what brings you don't the most, the rest look good for such age.

I'd fix it if I could. Brow position is so hard to change. Maybe you can do it with supras, but from what I understand the results are pretty variable and not reliable. If it was a predictable surgery I'd probably do it, but after ten procedures I'm not really looking to take a gamble on something that I might have to undo. But eye area is my biggest shortcoming.

 

[Win200]

Do you inject botox in ur under eye area?

Yes, in the lateral corners.

 

[Win200]

How much time did it take to heal from the genioplasty?

Also, did you add some fat grafts after getting the genio?

Which genioplasty?

 

[Mr.Proper]

I'd fix it if I could. Brow position is so hard to change. Maybe you can do it with supras, but from what I understand the results are pretty variable and not reliable. If it was a predictable surgery I'd probably do it, but after ten procedures I'm not really looking to take a gamble on something that I might have to undo. But eye area is my biggest shortcoming.

What about fat grafting and/or botox for that purpose?

 

[savemebimax]

You look great for 43 man

 

[Lefor3Laser]

I had a pretty active thread here four years ago about some Eppley infraorbital implants: https://looksmax.org/threads/removing-eppley-cheek-implants.378955/.

Since then, I've had bimax with Sam Bobek for sleep apnea, which had a great functional outcome but a bad aesthetic one. (Not really his fault; he had to take out a Yaremchuk jaw implant from 2016, which caused a lot of neck jowling/sagging.)

Here's my full surgery rundown:

• 2011 - rhinoplasty and chin implant - Wayne Larrabee
• 2012 - hair transplant - Robert Niedbalski
• 2013 - revision rhinoplasty - Wayne Larrabee
• 2015 - hair transplant - H. Rahal
• 2016 - custom wraparound jaw implant - Michael Yaremchuk
• 2020 - custom infraorbital implants - Barry Eppley (tried to do a replacement jaw implant, but couldn't remove Yaremchuk implant due to bone overgrowth)
• 2021 - lid retraction repair/canthoplasty/ptosis repair - A.J. Amadi (mainly to correct lower lid retraction on right side caused by lower eyelid incisions to place infraorbitals)
• 2022 - revision to size down infraorbitals via hand-carving and re-placing - Barry Eppley
• 2024 - bimax + genio for sleep apnea -Sam Bobek (including removal of Yaremchuk jaw implant)
• 2024 - additional attempt at lower lid retraction repair on right side (removal of Eppley infraorbital on right side and replacement with hand-carved ePTFE implant to provide structural support for lower lid)
• 2025 - revision rhinoplasty - Aaron Kosins
• 2025 - reduction genioplasty, jaw shaving, custom jaw angle implants, neck lift - Yirae Ort

I'm 43. Ask constructive questions and I'll give constructive answers. Before and after pics are below; I'm only 14 days PO with Ort, so there's some swelling, especially on the jawline.

View attachment 4266359View attachment 4266367

Congrats and welcome back, I’ve always wondered where you’d gone. Honestly, I think you’ve really ascended. With respect, your earlier look gave off a softer, more effeminate vibe, but now your new looks are much more balanced and refined. The new chin shape suits your features far better than the older, more squared one.

Again, congrats.

 

[RazerGlazer]

I had a pretty active thread here four years ago about some Eppley infraorbital implants: https://looksmax.org/threads/removing-eppley-cheek-implants.378955/.

Since then, I've had bimax with Sam Bobek for sleep apnea, which had a great functional outcome but a bad aesthetic one. (Not really his fault; he had to take out a Yaremchuk jaw implant from 2016, which caused a lot of neck jowling/sagging.)

Here's my full surgery rundown:

• 2011 - rhinoplasty and chin implant - Wayne Larrabee
• 2012 - hair transplant - Robert Niedbalski
• 2013 - revision rhinoplasty - Wayne Larrabee
• 2015 - hair transplant - H. Rahal
• 2016 - custom wraparound jaw implant - Michael Yaremchuk
• 2020 - custom infraorbital implants - Barry Eppley (tried to do a replacement jaw implant, but couldn't remove Yaremchuk implant due to bone overgrowth)
• 2021 - lid retraction repair/canthoplasty/ptosis repair - A.J. Amadi (mainly to correct lower lid retraction on right side caused by lower eyelid incisions to place infraorbitals)
• 2022 - revision to size down infraorbitals via hand-carving and re-placing - Barry Eppley
• 2024 - bimax + genio for sleep apnea -Sam Bobek (including removal of Yaremchuk jaw implant)
• 2024 - additional attempt at lower lid retraction repair on right side (removal of Eppley infraorbital on right side and replacement with hand-carved ePTFE implant to provide structural support for lower lid)
• 2025 - revision rhinoplasty - Aaron Kosins
• 2025 - reduction genioplasty, jaw shaving, custom jaw angle implants, neck lift - Yirae Ort

I'm 43. Ask constructive questions and I'll give constructive answers. Before and after pics are below; I'm only 14 days PO with Ort, so there's some swelling, especially on the jawline.

View attachment 4266359View attachment 4266367

you look great. Wide chin is cope and I'm amazed how many people fall for the trap of having a wide chin.

Yes sometimes it looks good but it depends on the width of the mouth, how wide is the jaw etc.

You look way better now.

 

[Win200]

you look great. Wide chin is cope and I'm amazed how many people fall for the trap of having a wide chin.

Yes sometimes it looks good but it depends on the width of the mouth, how wide is the jaw etc.

You look way better now.

Thanks, man, I appreciate it. I think the wide chins look fake on most people. That's really what made my jaw implant uncanny, not the gonial width. Most chins aren't blocky like that.

 

[Win200]

Congrats and welcome back, I’ve always wondered where you’d gone. Honestly, I think you’ve really ascended. With respect, your earlier look gave off a softer, more effeminate vibe, but now your new looks are much more balanced and refined. The new chin shape suits your features far better than the older, more squared one.

Again, congrats.

Thank you! I'll stick around and post more pics as the healing settles. I'm only 17 days PO so jawline is still really puffy. It'll get sharper and more angular in the next month.

 

[jon_chase89]

Good result. Jawline is now more Tom Cruise, less cartoon superman

 

[oganthropologist]

I had a pretty active thread here four years ago about some Eppley infraorbital implants: https://looksmax.org/threads/removing-eppley-cheek-implants.378955/.

Since then, I've had bimax with Sam Bobek for sleep apnea, which had a great functional outcome but a bad aesthetic one. (Not really his fault; he had to take out a Yaremchuk jaw implant from 2016, which caused a lot of neck jowling/sagging.)

Here's my full surgery rundown:

• 2011 - rhinoplasty and chin implant - Wayne Larrabee
• 2012 - hair transplant - Robert Niedbalski
• 2013 - revision rhinoplasty - Wayne Larrabee
• 2015 - hair transplant - H. Rahal
• 2016 - custom wraparound jaw implant - Michael Yaremchuk
• 2020 - custom infraorbital implants - Barry Eppley (tried to do a replacement jaw implant, but couldn't remove Yaremchuk implant due to bone overgrowth)
• 2021 - lid retraction repair/canthoplasty/ptosis repair - A.J. Amadi (mainly to correct lower lid retraction on right side caused by lower eyelid incisions to place infraorbitals)
• 2022 - revision to size down infraorbitals via hand-carving and re-placing - Barry Eppley
• 2024 - bimax + genio for sleep apnea -Sam Bobek (including removal of Yaremchuk jaw implant)
• 2024 - additional attempt at lower lid retraction repair on right side (removal of Eppley infraorbital on right side and replacement with hand-carved ePTFE implant to provide structural support for lower lid)
• 2025 - revision rhinoplasty - Aaron Kosins
• 2025 - reduction genioplasty, jaw shaving, custom jaw angle implants, neck lift - Yirae Ort

I'm 43. Ask constructive questions and I'll give constructive answers. Before and after pics are below; I'm only 14 days PO with Ort, so there's some swelling, especially on the jawline.

View attachment 4266359View attachment 4266367

Thanks for making this thread. I'm considering infraorbital implants with Dr. Pagnoni and received designs. I noticed in your OG thread on removing Eppley implants you mentioned you were somewhat happy with lateral projection, but didn't like the forward or infraortbial projection. Why is that?

I am being told my lateral projection is already good, and the Dr. only wants to advance me forward with infraorbitals and not really touch the sides. Curious what you think

 

[oganthropologist]

Thanks for making this thread. I'm considering infraorbital implants with Dr. Pagnoni and received designs. I noticed in your OG thread on removing Eppley implants you mentioned you were somewhat happy with lateral projection, but didn't like the forward or infraortbial projection. Why is that?

I am being told my lateral projection is already good, and the Dr. only wants to advance me forward with infraorbitals and not really touch the sides. Curious what you think

Also, how many MM large were the implants?

 

[vietmtn]

View attachment 4266359View attachment 4266367

You look way better after the jaw surgery

 

[ActualMax]

Mirin hard, did Steinsapir do your ePTFE implant? How were your results? @Win200

 

[Win200]

Good result. Jawline is now more Tom Cruise, less cartoon superman

Thanks much. I agree.

 

[Win200]

You look way better after the jaw surgery

Thank you!

 

[Win200]

Mirin hard, did Steinsapir do your ePTFE implant? How were your results? @Win200

He did. The reason for replacing Eppley's silicone implant on that side with an ePTFE implant was to hand-carve a replacement that could sit higher on the orbital rim to support that sagging lower lid, and provide what he called a "felting" material that the cheek could be lifted up and sutured onto for soft tissue support. The implant is not a perfect match, which isn't a surprise given that it's hand-carved rather than a custom implanted paired with the remaining one on the left side. The asymmetry bothers me a little, but not a bad tradeoff to correct the eye asymmetry. He successfully raised the lower lid a bit and also raised the lateral canthus.

Ort noticed the volumetric asymmetry between the two implants during surgery and mentioned that we could address it with filler or fat transfer. In a perfect world, I'd be able to drop in new, custom implants, but I think that would disrupt the eye revision work on the right side. And it would mean opening up the lower eyelid incision again, which is what caused the lid retraction in the first place. Too risky, I think. (And I believe Pagnoni has said, for example, that he won't don't malar implants on eyes that have had previous repairs for exactly that reason.)

 

[Win200]

Thanks for making this thread. I'm considering infraorbital implants with Dr. Pagnoni and received designs. I noticed in your OG thread on removing Eppley implants you mentioned you were somewhat happy with lateral projection, but didn't like the forward or infraortbial projection. Why is that?

I am being told my lateral projection is already good, and the Dr. only wants to advance me forward with infraorbitals and not really touch the sides. Curious what you think

I have deepset eyes naturally, so the anterior projection made them look even more recessed compared to my brow. Not a concern for everyone but didn't look right for me. Basically, I didn't have a midface deficit from a profile view; my issue was a lack of lateral projection/definition.

After Eppley revised the implants, the CT scan heatmap for my Ort surgery indicated that they were 2.5-3mm at the most prominent point in terms of lateral projection. MMs count a lot in malar implants and whenever I've seen ones that add like 4-5mm, they look uncanny and plastic. Adding that much lateral projection also makes your eyes look much closer together. Much better to add definition rather than volume, IMO.

 

[oganthropologist]

I have deepset eyes naturally, so the anterior projection made them look even more recessed compared to my brow. Not a concern for everyone but didn't look right for me. Basically, I didn't have a midface deficit from a profile view; my issue was a lack of lateral projection/definition.

After Eppley revised the implants, the CT scan heatmap for my Ort surgery indicated that they were 2.5-3mm at the most prominent point in terms of lateral projection. MMs count a lot in malar implants and whenever I've seen ones that add like 4-5mm, they look uncanny and plastic. Adding that much lateral projection also makes your eyes look much closer together. Much better to add definition rather than volume, IMO.

Really appreciate your reply! Am struggling to understand how anterior projection can make you look more recessed, if the whole purpose of projection is to correct recession?

Are you saying you have a really strong brow ridge, and this projection overshadowed it?

I agree too much lateral projection can look uncanny, I'm just not sure where I should add projection given my surgeon said my lateral cheekbones are already wide. Mind if I DM you photos for your opinion?

 

[savemebimax]

Did you have a lip lift at some point? both your lips have more volume and philtrum shorter than at 28.

 

[Win200]

Did you have a lip lift at some point? both your lips have more volume and philtrum shorter than at 28.

No lip lift. Kinda loosely considered it but I think they look pretty effeminate on men and if you don't pull a great scar, it's super obvious and nothing you can do about it. There's a tiny bit of filler in the lips for a little volume, and philtrum length probably looks different due to maxillary advancement from bimax.

 

[Win200]

Really appreciate your reply! Am struggling to understand how anterior projection can make you look more recessed, if the whole purpose of projection is to correct recession?

Are you saying you have a really strong brow ridge, and this projection overshadowed it?

I agree too much lateral projection can look uncanny, I'm just not sure where I should add projection given my surgeon said my lateral cheekbones are already wide. Mind if I DM you photos for your opinion?

If you have deepset eyes and you move the midface forward, you're increasing the length between the eyeball and the midface, making the eyeball appear farther back (which it literally will be compared to the midface). Moving the midface forward doesn't move the eye forward, so it doesn't do anything to address recessed eyes.