Removing Eppley cheek implants

Win200

Win200

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Update here.

Just had a long chat with Dr. Eppley. Explained to him that I have some reservations about the result and am considering (i) doing nothing; (ii) pure removal, and (iii) removal and replacement. I said that I'm leaning towards (iii) but concerned about cheek sagging.

He said:

  • Don't be worried about cheek sagging, either in removal or removal and replacement. It's incredibly rare for someone my age, the sagging concerns relate more to conventional cheek implants than custom malar/zygo/rim implants, and he would resuspend the cheek tissue. His bottom line: if you want to do either removal or replacement, do not let concerns about sagging deter you.
  • I asked about lower lid positioning given that I've had retraction repair after the last procedure. He said that if we do pure removal, we can take them out intraorally. If we replace, they've got to go in through the lower lid again. Either way, he said that yes, there is some risk that it changes the lower lid positioning, but (i) he thinks it's unlikely (especially that since the grafts placed in my lower lids will help support them), and (ii) even if it happens, it would be easily correctable and not a permanent problem (I explained that I just don't want to cause irreparable issues by undergoing another implant procedure).
  • He said that if we remove and replace, we don't need to do another custom. He said that he can manually shave my existing implants quite extensively, even to remove the tear trough area and all forward projection.
  • If I remove or remove and replace, recovery will be much easier than the first time around.
So, Eppley's bottom line is that risks associated with removal or removal and replacement are minimal and shouldn't be a deterrent to changing the implants. I'm leaning towards removal and replacement--well, removal and shaving down the existing implants to include about 1.5mm of zygo projection and eliminating the forward projection and tear trough support.

Curious about everyone's thoughts.
 
LastHopeForNorman

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Win200 said:
Here are two pics! Just did more on Wednesday and these are after, so the Restalyne will settle and even out. And there's still half a syringe that we're doing on top of that, so this isn't the final result. You can also see a bit of persistent right lower lid retraction, even after retraction repair. That will be corrected.

What about fat graft ?

Its permanent
You dont have think about it(no refills) ,no risk of migration


I will do fat graft for my uee in the future



If you choose good doctor there is almost no chance of forming lumps .

You are Rich so finding good doctor will be easy
 
mulattomaxxer

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I think your Cheek implants need removing, or atleast shaving down. Overall you look better post operation then before your surgery (based on the pictures posted here). You are correct your cheek implants are to big. Keep the jaw implant because your jaw looks good (I am assuming your planning on keeping it. The best surgery results are the ones which ascend you without it being obvious you have had surgery. Do you get lip fillers? I would reccomend avoiding them if you do.

One other thing I would like to mention is that I am very impressed at how youthful you look. You mog 99% of 38 year olds. You look like your in your mid twenties. What are your secrets? Currently I only use suncream and try to avoid using chemicals on my skin. I also go the gym x4 a week, but I want to make that x5-6 times a week in the future. I fatigue easily atm. Finally I eat healthy, only drink water and take multivitamins but I need to double check I am getting proper nutrients.

I think your UEE is your main flaw, apart from the cheek implants.
 
Win200

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mulattomaxxer said:
I think your Cheek implants need removing, or atleast shaving down. Overall you look better post operation then before your surgery (based on the pictures posted here). You are correct your cheek implants are to big. Keep the jaw implant because your jaw looks good (I am assuming your planning on keeping it. The best surgery results are the ones which ascend you without it being obvious you have had surgery. Do you get lip fillers? I would reccomend avoiding them if you do.

One other thing I would like to mention is that I am very impressed at how youthful you look. You mog 99% of 38 year olds. You look like your in your mid twenties. What are your secrets? Currently I only use suncream and try to avoid using chemicals on my skin. I also go the gym x4 a week, but I want to make that x5-6 times a week in the future. I fatigue easily atm. Finally I eat healthy, only drink water and take multivitamins but I need to double check I am getting proper nutrients.

I think your UEE is your main flaw, apart from the cheek implants.
Hey, thanks! Look earlier in this thread; I did a long writeup about my routine that will give you the info you're looking for.
 
Win200

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Win200 said:
Hey, thanks! Look earlier in this thread; I did a long writeup about my routine that will give you the info you're looking for.
Also, to answer your questions, no, I'm not removing the jaw implant. I love it. And I do have some lip fillers, but letting them slowly dissolve. After I get the cheeks squared away, I'm done with surgery. I'll get fillers to address the UEE and keep up the Botox regimen, but I just wanna go enjoy the face :)
 
Lolcel

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I think with that ogee , you need to get rid of the UEE (upper eyelid exposure) in order to avoid that feminine look
 
crosshold

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if keeping the jaw implant the same size then definitely dont shave down the lateral portion of the zygo implants, just the infraorbital area. and then get fat grafts to replace that basically

you can use fat grafts for UEE too im pretty sure
 
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Win200 said:
Here are two pics! Just did more on Wednesday and these are after, so the Restalyne will settle and even out. And there's still half a syringe that we're doing on top of that, so this isn't the final result. You can also see a bit of persistent right lower lid retraction, even after retraction repair. That will be corrected.
Results looking good so far
I wonder though just how much filler you can take in the upper eyelids, if you look at those with heavy hooding like Pitt or dicaprio it's their fat padding below the brows that creates the hooding along with vertically short eyelids.

Also do you recommend eyelid filler as a replacement for infraorbital implants?
 
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Win200

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crosshold said:
if keeping the jaw implant the same size then definitely dont shave down the lateral portion of the zygo implants, just the infraorbital area. and then get fat grafts to replace that basically

you can use fat grafts for UEE too im pretty sure
I'll probably reduce the lateral projection like .5mm, but also reduce the bulk of the malar portion of the implants; they look a little full/apple-cheeked and could be more angular.
 
randomvanish

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Win200 said:
I'll probably reduce the lateral projection like .5mm, but also reduce the bulk of the malar portion of the implants; they look a little full/apple-cheeked and could be more angular.
so plastic look coming from mostly anterior part right ? should we avoid anterior projection to get more masculine and natural ?
also please share the last design when you got it done with Dr.E.
 
Win200

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randomvanish said:
so plastic look coming from mostly anterior part right ? should we avoid anterior projection to get more masculine and natural ?
also please share the last design when you got it done with Dr.E.
Yes, I think most of the problem is (i) a little too much zygo projection as the implant turns the corner from the zygo to the malar area, and (ii) too much anterior projection, especially in the tear trough and undereye area. The latter is helping create the puffy, overfilled look.

Sadly, there probably won't be new renderings to share; Eppley said that he can do all these revisions by shaving and sculpting the existing implants, then dropping them back in.
 
crosshold

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really quick, what do you do for your skin again? i think you said you do ipl twice a year but what else?
 
mulattomaxxer

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Win200 said:
Here's a daily routine:

Wake up at 5:30am, wash face, have coffee, gym for 90 mins + 15 mins HIIT cardio.
Wash face with Sunday Riley ("SR") Blue Moon and then Ceramic Slip. Spray on SR Pink Drink. Layer on SR Good Genes. Apply Augustinus Bader The Rich Cream moisturizer.
Have breakfast--usually three eggs scrambled with tons of spinach and 1/2 lb ground beef or chicken (organic). Plus 1/2C oatmeal.

Lunch is usually 1/2 lb salmon on top of greens, whatever veggies are in the fridge, and a carb (rice, lentils, quinoa, beans, sweet potatoes).

After work, I try to do another 15 mins HIIT cardio before dinner (usually chicken and vegetables--I usually omit a carb for dinner to stay lean).

Bed routine is wash with the same two cleansers, then apply SR A+ and then SR Luna. Let dry. Mix a few drop of SR Juno oil into some SR Ice moisturizer, apply all over face. Go to bed on my back (sleeping on your chest/sides causes wrinkles).

Botox every three months, filler when/where necessary (I do the lips but understand straight guys don't). Before the implants, I got filler around the undereyes and cheeks/zygos. Now, just the lips and upper eyelids.

IPL twice a year. Facials every couple months--hydrofacials are great. Very little booze, no gluten, no dairy.
Mirin, but this is very expensive for poorcels like me. I need to save up for a bimax first. Also do you wear suncream?
 
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Forget the eyelids it’s the big ass duck lips making it look fake
 
Win200

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crosshold said:
really quick, what do you do for your skin again? i think you said you do ipl twice a year but what else?
There's a long post a page or two back detailing everything.
 
lilhorizontal32

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its hard for me to give you any advice without seeing your face properly.

post some photos of yourself from:

1. a front on position facing the camera
2. side profile (with your head tilted along the frankfurt plane) and
3. 3/4ths (oblique) view.

also do all of these photos again but with a full smile so we can assess your smile aesthetics

and make sure they arent selfies but taken by someone else with at least the back camera of a good phone (the front one is less clear), and from a distance of like 10ft or more to minimise lens distortion
 
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lilhorizontal32

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and have you talked to eppley about maybe getting browridge/supraorbital implants for your UEE, as a more permanent solution to fillers?

dont know too much about them tbh but Eppley will and he should also be able to comment as to their effectiveness in decreasing UEE in your case
 
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@ Win200 Win200 when I was consulting with Dr. Y about cheek implants, I showed him your design from Dr. Eppley as a reference and he immediately said it would look "uncanny". Maybe it's worth asking him for his opinion as well?

On a side note, do you remember if your jaw implant was made of silicon/medpor, and if it was silicon, was it porous silicon? Reading Dr. Y's publications it seems to imply he prefers using medpor, but I've seen a lot of his recent patients with silicon.
 
runescapeaddict1996

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Win200 said:
Previous discussion of my procedures/results is in this thread: https://looksmax.org/threads/new-implant-result-guy-with-cheek-and-jaw-implant-from-dr-e.236061/

Link to the rendering of the implants is here:
Bottom line is Eppley placed custom malar/infraorbital rim implants in November 2020. Now that I've had nine months with them, I'm pretty firm on getting them removed. They're too big in almost every way--lateral projection, forward projection, infraorbital rim augmentation. The ogee curve they form looks, to me, completely unnatural. The tear trough augmentation is a bit convex, which looks puffy, and the entire mid-section of my face is just oversized. It's particularly pronounced when I smile and all my cheek tissue is bunched up on top of the implants. One of the worst parts is that the augmentation around the eye socket creates an unnatural "ringing" around the lower half of my eye, making the eyes look sunken (you see this in the pic below where I'm holding my phone).

I just don't feel like I look like myself; every other procedure, I always saw myself in the end result, but this created a look that doesn't feel like me and the little bit of dysmorphia is unnerving.

Open to comments, and not sure if I'm doing a remove and replace with a smaller implant, or just a removal. (I'm concerned about cheek sagging with removal due to the capsule around the implants.)
Guy looks like he got bitch slapped one too many times as a child by his mother.
 
Win200

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falcolombobby said:
@ Win200 Win200 when I was consulting with Dr. Y about cheek implants, I showed him your design from Dr. Eppley as a reference and he immediately said it would look "uncanny". Maybe it's worth asking him for his opinion as well?

On a side note, do you remember if your jaw implant was made of silicon/medpor, and if it was silicon, was it porous silicon? Reading Dr. Y's publications it seems to imply he prefers using medpor, but I've seen a lot of his recent patients with silicon.
Interesting--did he say what he thought would make it look uncanny?

The jaw implant is silicone.
 
Win200

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lilhorizontal32 said:
and have you talked to eppley about maybe getting browridge/supraorbital implants for your UEE, as a more permanent solution to fillers?

dont know too much about them tbh but Eppley will and he should also be able to comment as to their effectiveness in decreasing UEE in your case
I did, but Eppley strongly recommended against doing them in order to achieve a hunter eye look; he didn't elaborate, but said while he would do them if I wanted them, he thought it was a bad idea. Seemed pretty insistent.
 
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Win200 said:
Interesting--did he say what he thought would make it look uncanny?

The jaw implant is silicone.
He didn't mention specifics, but i think he said the design overall with the big emphasis on the infraorbital ridge would look unnatural. If you look at the ones that Dr. Y makes, they look quite a bit different. When I asked him why he didn't like Eppley's design, he simply said "I like a more natural result, nobody's cheekbones look like that in real life (referring to the shape of Eppley's design). I think the has a few examples on his site, his deign wraps more of the entire cheek body and follows a more natural contour of the zygomatic body? I'm only guessing here, sorry I can't be more specific.
 

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randomvanish

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falcolombobby said:
He didn't mention specifics, but i think he said the design overall with the big emphasis on the infraorbital ridge would look unnatural. If you look at the ones that Dr. Y makes, they look quite a bit different. When I asked him why he didn't like Eppley's design, he simply said "I like a more natural result, nobody's cheekbones look like that in real life (referring to the shape of Eppley's design). I think the has a few examples on his site, his deign wraps more of the entire cheek body and follows a more natural contour of the zygomatic body? I'm only guessing here, sorry I can't be more specific.
what dr.y suggest shapewise in general ?
 
Win200

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falcolombobby said:
He didn't mention specifics, but i think he said the design overall with the big emphasis on the infraorbital ridge would look unnatural. If you look at the ones that Dr. Y makes, they look quite a bit different. When I asked him why he didn't like Eppley's design, he simply said "I like a more natural result, nobody's cheekbones look like that in real life (referring to the shape of Eppley's design). I think the has a few examples on his site, his deign wraps more of the entire cheek body and follows a more natural contour of the zygomatic body? I'm only guessing here, sorry I can't be more specific.

Interesting--thanks for sharing that. He was totally correct about the infraorbital ridge, which is the component of the implant that looks the most unnatural. I think I'm going to have Eppley remove the implant and shave it to remove that portion, then reduce the zygo projection by about 1.5mm. That should do the trick.

And yes, Y's implant designs do seem fundamentally different than Eppley's.
 
Win200

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Got an estimate back from Eppley to remove the cheek implants, shave/alter them, and stick them back in--super reasonable. Just agonizing over whether to just remove them, period, or shave them. I'm just worried about altering them and still coming out with it looking uncanny or not quite right. I know I looked good without them, so removal seems... safer? Idk. Really undecided.
 
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Win200 said:
Got an estimate back from Eppley to remove the cheek implants, shave/alter them, and stick them back in--super reasonable. Just agonizing over whether to just remove them, period, or shave them. I'm just worried about altering them and still coming out with it looking uncanny or not quite right. I know I looked good without them, so removal seems... safer? Idk. Really undecided.
If you never struggled with people telling you that you look sad or tired( because of weak infraorbitals, undereye support ) then I would get them removed. In my opinion the less foreign material in the face the better, you look great with the jaw implant already Brad Pitt has a great Jaw but his cheekbones are almost not visible but that doesn’t make him any more or less attractive.
Now if you are going for a certain look then I guess trimming those cheekbone implants is worth the shot
 
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Win200

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need-a-wide-jaw said:
If you never struggled with people telling you that you look sad or tired( because of weak infraorbitals, undereye support ) then I would get them removed. In my opinion the less foreign material in the face the better, you look great with the jaw implant already Brad Pitt has a great Jaw but his cheekbones are almost not visible but that doesn’t make him any more or less attractive.
Now if you are going for a certain look then I guess trimming those cheekbone implants is worth the shot
Never got those comments, and, honestly, filler had worked really well at augmenting the infraorbital rim. I'm not opposed to having an implant there, I'm just worried about having another result that doesn't look quite right and having to surgically intervene AGAIN. Implants are great, but I've found out that the tough part is hitting a target that you can't fully see until the implants are in there--it's a lot of guesswork, while filler can be placed bit by bit and it's much easier to see what you're doing as you go along.
 
PapiMew

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Win200 said:
Never got those comments, and, honestly, filler had worked really well at augmenting the infraorbital rim. I'm not opposed to having an implant there, I'm just worried about having another result that doesn't look quite right and having to surgically intervene AGAIN. Implants are great, but I've found out that the tough part is hitting a target that you can't fully see until the implants are in there--it's a lot of guesswork, while filler can be placed bit by bit and it's much easier to see what you're doing as you go along.
Fillers will continue to migrate for over half a decade

I'm sure you've seen this video:


In the short term, fillers can give better a better aesthetic augmentation but that comes with serious long-term drawbacks. I've seen it time and time again.
 
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T
PapiMew said:
Fillers will continue to migrate for over half a decade

I'm sure you've seen this video:


In the short term, fillers can give better a better aesthetic augmentation but that comes with serious long-term drawbacks. I've seen it time and time again.
There is yet to be a peer reviewed study where it proves the theory of filler migration, so far there’s only anecdotal evidence and anti-filler people who never got filler themselves always link to the same video as their “evidence”.
 
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need-a-wide-jaw said:
T

There is yet to be a peer reviewed study where it proves the theory of filler migration, so far there’s only anecdotal evidence and anti-filler people who never got filler themselves always link to the same video as their “evidence”.
We can agree to disagree.

I've spent thousands on filler myself and I didn't get any migration myself but I am not going to ignore the abundance of evidence. I know you've spent thousands on filler as well. You seem a bit biased. AFAIK you haven't even had filler for half a year yet, have you?


Also, a vast majority of PSLers don't want conservative results. Wanting a dramatic result with fillers is a recipe for disaster.
 
FootLongDong

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Im wondering what do you do for a living?

Also pretty gl
 
Acromegaly_Chad

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Remove reshape replace. RRR.

Ask for local anaesthesia though, it's commonly supported evidence that full anaesthesia lowers the IQ.

With that being said: Implants almost ALWAYS look fake. Only PEEK implants that are conservative produce natural looking results imo. I instantaneously spotted that you had work done and I think good plastic surgery is so natural that one wouldn't know.
 
Win200

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Acromegaly_Chad said:
Remove reshape replace. RRR.

Ask for local anaesthesia though, it's commonly supported evidence that full anaesthesia lowers the IQ.

With that being said: Implants almost ALWAYS look fake. Only PEEK implants that are conservative produce natural looking results imo. I instantaneously spotted that you had work done and I think good plastic surgery is so natural that one wouldn't know.
I'm leaning towards replacement after dramatically shaving the implants down. I think that would also help avoid a potential issue of capsule slippage and resulting cheek sagging--better to have something in there than empty the capsules completely.

Interesting about IQ. I did some quick Googling and only find some preliminary findings of very slight memory impairment among young children who are still neurologically developing, but nothing about adults.
 
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Acromegaly_Chad said:
Remove reshape replace. RRR.

Ask for local anaesthesia though, it's commonly supported evidence that full anaesthesia lowers the IQ.

With that being said: Implants almost ALWAYS look fake. Only PEEK implants that are conservative produce natural looking results imo. I instantaneously spotted that you had work done and I think good plastic surgery is so natural that one wouldn't know.
What do you think of Titanium?
 
Win200

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I asked Eppley to add fat grafting to the UEE area to the remove & shave procedure I'm booking with him.
 
Win200

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I'm thinking of consulting w/ Y to see what he says; I'm a little nervous about pulling another unnatural look with Eppley reshaping the existing implants. Y's bedside manner sucks, but I think his custom cheek implants are more natural looking and I'm curious what he says.
 
Amnesia

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Great thread dude.

I just want to add since people on here always ask what I attribute my young looks to given I am 33. I also follow a gluten free diet and have had over 8 sessions of IPL like OP. I think gluten free diet is key, I also had IBS like OP and gluten free diet is what got rid of it. Also my skin got SO much better once going gluten free

Just my two cents. Appreciate the updates OP good luck with everything, I will follow your threads closely
 
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Acromegaly_Chad said:
Ask for local anaesthesia though, it's commonly supported evidence that full anaesthesia lowers the IQ.
Where did you get that from?
 
RIPPED IRL

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Win200 said:
Here's a daily routine:

Wake up at 5:30am, wash face, have coffee, gym for 90 mins + 15 mins HIIT cardio.
Wash face with Sunday Riley ("SR") Blue Moon and then Ceramic Slip. Spray on SR Pink Drink. Layer on SR Good Genes. Apply Augustinus Bader The Rich Cream moisturizer.
Have breakfast--usually three eggs scrambled with tons of spinach and 1/2 lb ground beef or chicken (organic). Plus 1/2C oatmeal.

Lunch is usually 1/2 lb salmon on top of greens, whatever veggies are in the fridge, and a carb (rice, lentils, quinoa, beans, sweet potatoes).

After work, I try to do another 15 mins HIIT cardio before dinner (usually chicken and vegetables--I usually omit a carb for dinner to stay lean).

Bed routine is wash with the same two cleansers, then apply SR A+ and then SR Luna. Let dry. Mix a few drop of SR Juno oil into some SR Ice moisturizer, apply all over face. Go to bed on my back (sleeping on your chest/sides causes wrinkles).

Botox every three months, filler when/where necessary (I do the lips but understand straight guys don't). Before the implants, I got filler around the undereyes and cheeks/zygos. Now, just the lips and upper eyelids.

IPL twice a year. Facials every couple months--hydrofacials are great. Very little booze, no gluten, no dairy.
Do you do 2 HIIT sessions every training day?
 
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Win200 said:
I asked Eppley to add fat grafting to the UEE area to the remove & shave procedure I'm booking with him.
When did you book all this? Interested to see the results
 
medialcanthuscel

medialcanthuscel

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The only problem is the lack of the saddle

By the way in your instagram photos you look fine, cheekbones are good

Do not remove the implants please, I'm the biggest expert on this forum, trust me
 
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Win200

Win200

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chedurak said:
When did you book all this? Interested to see the results
Haven't booked yet; just have the estimate. Closing on a house today so have to wait for that to wrap up before I can throw down the deposit money.
 
Win200

Win200

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medialcanthuscel said:
The only problem is the lack of the saddle

By the way in your instagram photos you look fine, cheekbones are good

Do not remove the implants please, I'm the biggest expert on this forum, trust me
So you'd recommend revising them down?
 
Deusmaximus

Deusmaximus

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Please be honest and share your current cycle with us.

 

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