Rate my hardmaxx plan + suggestions

[es5123]

-Scalp advancement surgery since i am not receding (have had this shit hairline + big forehead since i was a kid). Other option is a HT.
-Fat grafting or something similar to improve supraorbital area
-Either a mid facelift, fat grafting, implants or all of them. Was considering implants first but not impressed by the results i have seen. Simultaneously lift lower eyelid.
-Slight nose tip lift while keeping the nose straight for harmony. Will most likely try filler since change that small will not like be worth 8-10k.
-Small genio to give more vertical length to lower third and (taller chin) + advacement and hopefully they will push the lower lip a bit forward to make lips more balanced. Maybe a slight widening as well.

Not sure if its worth to do anything to jaw angles, atleast i dont need widening but taller looking ramus is always nice.

Did only side morph since its a lot easier than front.

 

[chrishell]

Even if you are not balding if you have a natural horshoe shape HT is preferable to scalp advancement

I agree with rhino

I can't comment on the midface with this one angle

 

[es5123]

Even if you are not balding if you have a natural horshoe shape HT is preferable to scalp advancement

I agree with rhino

I can't comment on the midface with this one angle

Here is a pick from the front. Had to put some blur in even tho probably makes no difference lol.
Those lowered sagging fat pads annoy me the most, they dont look bad here but are worse in some angles. Also the hollow undereyes combined with slight scleral show make me look tired.

I also have some undereye filler here but probably makes no difference

 

[chrishell]

Here is a pick from the front. Had to put some blur in even tho probably makes no difference lol.
Those lowered sagging fat pads annoy me the most, they dont look bad here but are worse in some angles. Also the hollow undereyes combined with slight scleral show make me look tired.

I also have some undereye filler here but probably makes no difference

How old are you

post 3/4

 

[es5123]

How old are you

post 3/4

25

 

[chrishell]

25

Are you Balkan by chance

With low set soft tissues and a relative deficiency of infraorbital fat you are at increased risk for a lot of the common infrazygo implant issues. If you increase projection in the undereye area while having low set soft tissues it will give the illusion as if your fat pads have sagged more than they actually have: you would be trading off better projection for the illusion of advanced midface aging that would require generalized fat grafting and potentially an endoscopic subperiosteal midface lift to solve. Nobody talks about this but these issues are much more common than is passed off here. Consult with ramieri and pagnoni and see what they think about implants here though since I can't tell entirely due to lighting and angles and so forth.

I would consult an oculoplastic surgeon who has experience in malar tissue repositioning + small infra implants as well. If your fat pads have been like that for a while it may not be due to aging-related malar pad ptosis but simply a low set periosteum which must be elevated. Or the fat pads themelves are just naturally low set and need to be pulled up. You would get several more mm in projection in the upper midface anyway from doing these procedures for what its worth. Many women who undergo subperiosteal midface lift for example often complain their zygos get too wide from the operation.

 

[es5123]

Are you Balkan by chance

With low set soft tissues and a relative deficiency of infraorbital fat you are at increased risk for a lot of the common infrazygo implant issues. If you increase projection in the undereye area while having low set soft tissues it will give the illusion as if your fat pads have sagged more than they actually have: you would be trading off better projection for the illusion of advanced midface aging that would require generalized fat grafting and potentially an endoscopic subperiosteal midface lift to solve. Nobody talks about this but these issues are much more common than is passed off here. Consult with ramieri and pagnoni and see what they think about implants here though since I can't tell entirely due to lighting and angles and so forth.

I would consult an oculoplastic surgeon who has experience in malar tissue repositioning + small infra implants as well. If your fat pads have been like that for a while it may not be due to aging-related malar pad ptosis but simply a low set periosteum which must be elevated. Or the fat pads themelves are just naturally low set and need to be pulled up. You would get several more mm in projection in the upper midface anyway from doing these procedures for what its worth. Many women who undergo subperiosteal midface lift for example often complain their zygos get too wide from the operation.

Thanks for the tips.
Not a balkan but i have heard that reference before.

This is pretty much exactly what i was worried about with the implants and why i been searching about midface lifts since i want that fat pad to be lifted/gone not just added mass above it.

I am about to book a consult with an oculoplastic surgeon.

Btw i have had a bimax already, which maybe even made the sagging more prominent, either via maxillary advancement pushing the soft tissues or because i started to look a lot more leaner on my lower third. However i have always had low set soft tissues and are not due to agning.

 

[chrishell]

Thanks for the tips.
Not a balkan but i have heard that reference before.

This is pretty much exactly what i was worried about with the implants and why i been searching about midface lifts since i want that fat pad to be lifted/gone not just added mass above it.

I am about to book a consult with an oculoplastic surgeon.

Btw i have had a bimax already, which maybe even made the sagging more prominent, either via maxillary advancement pushing the soft tissues or because i started to look a lot more leaner on my lower third. However i have always had low set soft tissues and are not due to agning.

What kind of movements were on your bimax?

Do you still have the plates?

 

[ltn_looksminner]

Here is a pick from the front. Had to put some blur in even tho probably makes no difference lol.
Those lowered sagging fat pads annoy me the most, they dont look bad here but are worse in some angles. Also the hollow undereyes combined with slight scleral show make me look tired.

I also have some undereye filler here but probably makes no difference

Is it possible to get rid of that fat ? I heard median or whatever that area is called cannot be removed even with surgery cause its risky

 

[es5123]

What kind of movements were on your bimax?

Do you still have the plates?

Maxilla advanced 6mm, mandible +10 and some CW to go.
I still have the plates.
Here is a before pic

 

[chrishell]

Maxilla advanced 6mm, mandible +10 and some CW to go.
I still have the plates.

How long postop are you? If you are less than 2 years, there is likely still some swelling remaining there. LeFort area puffiness takes a very long time to go away. I see this in almost every jaw surgery patient.

You can also look into Kybella injection (I know someone who did one to this area), hydrocortisone injection if there is any excessive scarring, fat grafts to smooth the transition in the area of the LeFort cut, or the fat just needs to be redraped.

 

[es5123]

How long postop are you? If you are less than 2 years, there is likely still some swelling remaining there. LeFort area puffiness takes a very long time to go away. I see this in almost every jaw surgery patient.

You can also look into Kybella injection (I know someone who did one to this area), hydrocortisone injection if there is any excessive scarring, fat grafts to smooth the transition in the area of the LeFort cut, or the fat just needs to be redraped.

Its few years ago. I thought first that it might be swelling but no change in long time.

Will look into it, thanks. Will see what an oculoplastic has to say

 

[chrishell]

Ok good luck and nice jaw surgery result btw