Removing Eppley cheek implants

[Win200]

i been saving to get the Custom infraorbital - malar implant from eppley and you were one of the best results I’ve seen so far, I still dk why you gonna get it removed. How much was the first deposit for the surgery with Eppley?

Honestly, it's way too big. The undereye augmentation has way too much anterior projection and it creates a weird gaunt look, like my eyes are too deeply recessed now with the anterior augmentation. I really think augmentation the infraorbital area is extremely tricky and can look unnatural easily. Mine looks like about four syringes of Restalyne were stuffed under each eye.

 

[Win200]

i been saving to get the Custom infraorbital - malar implant from eppley and you were one of the best results I’ve seen so far, I still dk why you gonna get it removed. How much was the first deposit for the surgery with Eppley?

Here's a picture that illustrates pretty well how the implants look unnatural; see how the light is bouncing off that circular ring below my eye? That's not what a malar contour naturally looks like. (Ignore the shiny skin; I was sweating post-workout.)

 

[Huncho02]

Here's a picture that illustrates pretty well how the implants look unnatural; see how the light is bouncing off that circular ring below my eye? That's not what a malar contour naturally looks like. (Ignore the shiny skin; I was sweating post-workout.)

I feel you, but the zygomatic arch is honestly the best part of that implant, so if you going to get the Infraorbital removed and keep the zygos I guess is a good idea. If you look at saiyans implant his infraorbital area is not as prominent as yours but his Zygo arch is what made him look great

 

[Huncho02]

Here's a picture that illustrates pretty well how the implants look unnatural; see how the light is bouncing off that circular ring below my eye? That's not what a malar contour naturally looks like. (Ignore the shiny skin; I was sweating post-workout.)

Also can you tell me how much was the first deposit for zygo implant and how much you actually ended up paying afterwards

 

[Win200]

I feel you, but the zygomatic arch is honestly the best part of that implant, so if you going to get the Infraorbital removed and keep the zygos I guess is a good idea. If you look at saiyans implant his infraorbital area is not as prominent as yours but his Zygo arch is what made him look great

Yup, I'll keep the zygo portion. I'm thinking of having Eppley carve them into something like the attached.

Is there a link to Saiyan's results?

 

[Win200]

Also can you tell me how much was the first deposit for zygo implant and how much you actually ended up paying afterwards

I don't remember the deposit amount. Remember I was scheduled to have jaw + malar, so my deposit, whatever it was, reflected that. I couldn't give you figures for malar alone.

 

[Deleted member 7098]

Yup, I'll keep the zygo portion. I'm thinking of having Eppley carve them into something like the attached.

Is there a link to Saiyan's results?

@Saiyan you deleted your thread on Lookism, right?

that‘s what he looks like.

And that is the thread with his ct-scans

CT Scan 2 years post zygo implants - no bone erosion and no change of placement (pics+gif)

So I've just had full CT scan almost 2 years post surgery. As you can see from pics they are still perfectly placed and official radiographer's feedback was that my bone underneath is exactly the same size as before. It's pretty interesting how you can see the bone before surgery and with...

looksmax.org

 

[Win200]

@Saiyan you deleted your thread on Lookism, right?

that‘s what he looks like.
View attachment 1422595View attachment 1422596View attachment 1422603

And that is the thread with his ct-scans

CT Scan 2 years post zygo implants - no bone erosion and no change of placement (pics+gif)

So I've just had full CT scan almost 2 years post surgery. As you can see from pics they are still perfectly placed and official radiographer's feedback was that my bone underneath is exactly the same size as before. It's pretty interesting how you can see the bone before surgery and with...

looksmax.org

Awesome, thanks so much--I think the clear difference is that his undereye area wasn't NEARLY as augmented as mine. The anterior projection at the outer edge of the cheekbone is actually greater than below the eye close to the nose; that helps give him the hollow cheek look. That area is way to full in me and actually projects MORE than the cheekbone--i.e., way too much augmentation and projection towards the middle of the face.

 

[Huncho02]

Awesome, thanks so much--I think the clear difference is that his undereye area wasn't NEARLY as augmented as mine. The anterior projection at the outer edge of the cheekbone is actually greater than below the eye close to the nose; that helps give him the hollow cheek look. That area is way to full in me and actually projects MORE than the cheekbone--i.e., way too much augmentation and projection towards the middle of the face.

I was also thinking that because you also have a big jaw implant it kinda makes the cheek implant look different compared to others since your jaw angles are wider than the lateral cheek area ( Zygo arch). If you look at saiyans he is literally clenching but his jaw is slim which makes the cheek implant looks at its best

 

[Win200]

I was also thinking that because you also have a big jaw implant it kinda makes the cheek implant look different compared to others since your jaw angles are wider than the lateral cheek area ( Zygo arch). If you look at saiyans he is literally clenching but his jaw is slim which makes the cheek implant looks at its best

Yeah, that's why I'm not going to narrow the lateral cheek area too much; maybe take 1.5mm off each side. The cheek area needs some augmentation given how wide the jaw is.

 

[Win200]

Attaching some pics I took this morning when I got up. I'm wondering if I could ask Steinbacher/Eppley to try to address the persistent lower lid retraction on my right side (on the left side of the pics) at the same time they work on the malar implants. I just feel like my eye region could be better, but not sure what the solution is; fixing the malar implants and reducing the infraorbital augmentation will probably help, and I'm going to continue adding upper eyelid filler. But maybe lengthening my PFL? I was reading about Eppley's drill hole canthoplasty and wonder if that would be helpful for me. I think the left eye--where the lid retraction repair worked--looks pretty good and has a nice shape.

I might have Steinbacher do a rhino revision, too. He said he can thin the skin at the tip down and reduce the bulby look, and give it some more angularity at the same time. I trust him a lot.

I also kinda wish I'd had a genio before doing the jaw implant, but not sure that's worth it now. You can see that there's definitely some chin recession, even with the jaw implant.

But definitely convinced that straight removal of the malars isn't the way to go; I need some lateral malar/zygo augmentation.

 

[Deleted member 7098]

Attaching some pics I took this morning when I got up. I'm wondering if I could ask Steinbacher/Eppley to try to address the persistent lower lid retraction on my right side (on the left side of the pics) at the same time they work on the malar implants. I just feel like my eye region could be better, but not sure what the solution is; fixing the malar implants and reducing the infraorbital augmentation will probably help, and I'm going to continue adding upper eyelid filler. But maybe lengthening my PFL? I was reading about Eppley's drill hole canthoplasty and wonder if that would be helpful for me. I think the left eye--where the lid retraction repair worked--looks pretty good and has a nice shape.

I might have Steinbacher do a rhino revision, too. He said he can thin the skin at the tip down and reduce the bulby look, and give it some more angularity at the same time. I trust him a lot.

I also kinda wish I'd had a genio before doing the jaw implant, but not sure that's worth it now. You can see that there's definitely some chin recession, even with the jaw implant.

But definitely convinced that straight removal of the malars isn't the way to go; I need some lateral malar/zygo augmentation.

Coincidentally, the thread i tagged you in, of the $600k surgery guy, also speaks of eppleys drill hole canthoplasty and eppley being the one that finally did the lower eye-lid retraction to his liking, after beint dissatisfied with the Taban results

might be worth for you to shoot the guy a PM or @ him in his thread, he truly knows a lot after going through so many doctor‘s hands

 

[Win200]

Coincidentally, the thread i tagged you in, of the $600k surgery guy, also speaks of eppleys drill hole canthoplasty and eppley being the one that finally did the lower eye-lid retraction to his liking, after beint dissatisfied with the Taban results

might be worth for you to shoot the guy a PM or @ him in his thread, he truly knows a lot after going through so many doctor‘s hands

Yup, that's where I got the idea of the drill hole canthoplasty. I honestly hadn't thought of Eppley for oculoplastic work and I usually try to go to specialists, but if he's going to re-do the malars (TBD between him and Steinbacher), maybe he can fix the eye at the same time.

That's not the first person I've heard have a negative experience with Taban.

 

[Huncho02]

Attaching some pics I took this morning when I got up. I'm wondering if I could ask Steinbacher/Eppley to try to address the persistent lower lid retraction on my right side (on the left side of the pics) at the same time they work on the malar implants. I just feel like my eye region could be better, but not sure what the solution is; fixing the malar implants and reducing the infraorbital augmentation will probably help, and I'm going to continue adding upper eyelid filler. But maybe lengthening my PFL? I was reading about Eppley's drill hole canthoplasty and wonder if that would be helpful for me. I think the left eye--where the lid retraction repair worked--looks pretty good and has a nice shape.

I might have Steinbacher do a rhino revision, too. He said he can thin the skin at the tip down and reduce the bulby look, and give it some more angularity at the same time. I trust him a lot.

I also kinda wish I'd had a genio before doing the jaw implant, but not sure that's worth it now. You can see that there's definitely some chin recession, even with the jaw implant.

But definitely convinced that straight removal of the malars isn't the way to go; I need some lateral malar/zygo augmentation.

Damn man your malar looks great, I feel you should not add more even on lateral area might end up looking overdone. But yes the eye area can be corrected

 

[Win200]

Damn man your malar looks great, I feel you should not add more even on lateral area might end up looking overdone. But yes the eye area can be corrected

Sorry, I was unclear--I'm not going to add any lateral projection. I meant that when I have Eppley revise them and reduce the infraorbital augmentation, I'm not going to have him shave down the lateral augmentation too much. By "I need some lateral malar/zygo augmentation," I meant that my natural bone structure needs augmentation there.

I think that whole area is going to look fantastic once the undereye area is fixed and the lid retraction is fully repaired.

 

[coke]

Looking at your Instagram you looked great before, I don’t see much difference but I actually think you looked more natural without the cheek implants.

The only thing you should try correct is the UEE, that’s literally the only flaw I can see, other than that you’re nailing your niche. I imagine you walk in a gay bar and you’re pretty popular haha!

 

[Win200]

Looking at your Instagram you looked great before, I don’t see much difference but I actually think you looked more natural without the cheek implants.

The only thing you should try correct is the UEE, that’s literally the only flaw I can see, other than that you’re nailing your niche. I imagine you walk in a gay bar and you’re pretty popular haha!

Yeah, I agree that that I looked more natural. Shaving them down should fix that.

 

[Deleted member 3679]

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.

Did this guy get a good result? Can you PM before/afters?

 

[zeek]

Any update? @Win200

 

[Win200]

@Win200

my knowledge of the malar and eye area is very poor however

ive looked at your pics a lot and I truly think the biggest ‘harmony breaker’ is how you have the “”chad”” very forward grown/developed zygos, jaw, yet your eyes have tons of UEE

You don’t look uncanny when I remove the UEE. Ill attach some shitty morphs.

I only edited your eyes and eyebrows.
View attachment 1489422I think @Danish_Retard was spot on in his assessment last year that the zygos are not necessarily the cause of being uncanny.

Hey, thanks, I appreciate the morphs and the thoughts. I think part of the problem is that you're not seeing things in motion, and only from certain angles. From head-on in a static photograph, it looks fine. In reality, the infraorbital augmentation is really overdone and looks puffy; there's been a LOT of volume added between the jaw and the malar/zygo implants, and it just has an "overfilled" quality. You know when people get too much filler and they have the "pillow face" that looks like it's full of soft filler and doesn't have any bone structure any more? It's a little like that.

I definitely think getting the implants shaved down--not removed--is the way to go. Eppley is also adding as much Restalyne to the upper eyelids as he can during surgery to correct the UEE.

 

[Win200]

Any update? @Win200

Nothing yet! Surgery is 2/10, so things will be quiet until then. I'm still talking to Steinbacher about revising the jaw, which looks like it might be possible. It really is too big, slightly, and my face would harmonize better if it's smaller and more angular.

 

[zeek]

Nothing yet! Surgery is 2/10, so things will be quiet until then. I'm still talking to Steinbacher about revising the jaw, which looks like it might be possible. It really is too big, slightly, and my face would harmonize better if it's smaller and more angular.

@Win200 Nice just a month from now!

I think your jaw looks very good, maybe just a tad much at the chin area.

1) Are you planning to revise other parts of the jaw implant as well or just the chin?

2 )And for the infraorbitalmalar implants, is Eppley just revising those as well to remove the inner part under the eyes?

I'm having rhinoplasty in a month and a half and consulting with different surgeons about the infraorbitalmalar implants, I definitely need them, just a bit worried about getting it right now.

3) Was there a reason why you didn't have Dr Y do the infraorbitalmalar implants as well and went to Eppley? It seems to be his strength. I'm definitely going to consult with him and Eppley, I'm just worried Eppley will overdo the width of the cheeks.

 

[Win200]

@Win200 Nice just a month from now!

I think your jaw looks very good, maybe just a tad much at the chin area.

1) Are you planning to revise other parts of the jaw implant as well or just the chin?

2 )And for the infraorbitalmalar implants, is Eppley just revising those as well to remove the inner part under the eyes?

I'm having rhinoplasty in a month and a half and consulting with different surgeons about the infraorbitalmalar implants, I definitely need them, just a bit worried about getting it right now.

3) Was there a reason why you didn't have Dr Y do the infraorbitalmalar implants as well and went to Eppley? It seems to be his strength. I'm definitely going to consult with him and Eppley, I'm just worried Eppley will overdo the width of the cheeks.

Yeah, the jaw isn't bad, but it's definitely a bit bulky. And yes, the chin is still too big even after Eppley shaved it down. If I redo it, it'll be a removal of the entire implant. Jaw surgery might be on the table; I got diagnosed with sleep apnea, and Steinbacher might be able to do jaw surgery that corrects it and moves the jaw forward at the same time. We'll see.

Correct on number 2. Removing the infraorbital area, narrowing the zygo projection a smidge (like 1mm on each side), making the remaining implants a bit sharper/more angular. Think of it as de-bulking the implants to reduce volume.

Yes--I thought Y's jaw implant was a bit big, so wanted to switch it up. Plus, was excited about working with Eppley.

 

[zeek]

Yeah, the jaw isn't bad, but it's definitely a bit bulky. And yes, the chin is still too big even after Eppley shaved it down. If I redo it, it'll be a removal of the entire implant. Jaw surgery might be on the table; I got diagnosed with sleep apnea, and Steinbacher might be able to do jaw surgery that corrects it and moves the jaw forward at the same time. We'll see.

Correct on number 2. Removing the infraorbital area, narrowing the zygo projection a smidge (like 1mm on each side), making the remaining implants a bit sharper/more angular. Think of it as de-bulking the implants to reduce volume.

Yes--I thought Y's jaw implant was a bit big, so wanted to switch it up. Plus, was excited about working with Eppley.

Gotcha, it definitely seems like Eppley is more willing to be someone you can "work" with as compared to Y which many see as an advantage.

If you do orthognathic surgery for the jaw to try and cure the OSA, that would be great for function and improve natural aesthetics but you'd have to go back again later to do another custom implant? Do you think you would go with Steinbacher for that or back to Dr Y or Dr E.

I'm consulting with a surgeon right now on whether to do Bimax vs lower jaw only to *prevent* sleep apnea/expand airway even though I look normal and have a "good" bite from orthodontics. My chin is a little short, but I'm going to do jaw surgery first and then a custom implant. I'm interested in Steinbacher as well for custom, but he doesn't have the body of cosmetic work I can evaluate like Y and E. Would love to hear more about what you think of him and his ideas.

 

[Win200]

Update here: had surgery with Eppley two days ago and flew home same day. He removed the malar implants, shaved them down, and replaced them. He also re-did the lower eyelid incision on the right side to tighten it and pull up the lower lid that was still retracted a bit even after the repair with AJ Amadi here in Seattle.

I'm still swollen, obviously, but all looks well. Eppley revised the implants to completely eliminated the infraorbital portion and size down the remaining portions--i.e., the ogee projection and the lateral projection of the zygos. Even with swelling, it looks MUCH better without the infraorbital augmentation and reduced ogee curve. (My mother said, "I wouldn't have told you before, but it looked unnatural and it's much better now.") I will say, though, that I told Eppley to reduce the lateral projection of the implants and I'm having a hard time telling the difference. Obviously I'll wait until the swelling goes down, but my hunch is that they'll still be a bit wider than I would prefer. We'll see. I knew it would be tough to give a surgeon instructions on how to revise a custom implant during surgery, when I'll be asleep and can't comment on what he's doing. Based on how the right eye looks so far, I think Eppley nailed it and it's going to be virtually identical to the left eye (which looks perfect). Hopefully I don't come to eat those words.

Like I said, I flew back the same day as surgery (about ten hours after I got out) so I could get home before swelling peaked. The five hour flight sucked because I was still loopy from the anesthesia. (The anesthesia doc was great, BTW--first time I've been under general where I couldn't tell that my throat had been intubated afterwards.) Even 56 hours post-op, there isn't THAT much swelling--the left side, where Eppley didn't need to revise the eye, is a little spongy, and both sides have swelling around the lower cheeks/jowls from the intraoral incisions. The right side is MUCH more swollen because those lower eyelid incisions really make your face blow up, but even that is going away quickly. (I forgot how these surgeries are a cycle of waking up in the morning with TONS of swelling, the swelling going down during the day, then waking up with more swelling--but slightly less than the day before--until it's gone away completely. So you look rough in the morning and pretty good in the evening for a week or two.) Haven't needed the percocets he prescribed.

Also--Eppley actually found the plastic versions of my implants and we drew on those during the preop as a guide for him to use during surgery. (ImplanTech sends a hard plastic version of the implants along with the silicone ones, and Eppley saves them for a few years--he showed me this big box of hundreds of malar implants and we were able to find mine.)

So, all in all a great experience with results looking on-point, even if the lateral projection still winds up a bit too wide. Eppley has some minuses to go along with his many plusses, and they've been discussed here a lot, but I'll add that I really enjoy working with him. He's friendly, not egocentric at all, listens, and follows up (he gave me a call the day after surgery to check in). It never seemed to bother him that I wanted to revise his design and he genuinely listened to my input when we discussed the changes I wanted during preop.

One last thing worth mentioning--he wasn't able to put screws into the implants when he put them back in. Because we eliminated all the infraorbital support, the implants sat really high in the pockets and he couldn't get access through intraoral incisions to place screws (i.e., the implants sort of went up and back in relation to the incisions). But he didn't think there would be a problem with movement.

I'll keep the thread updated as I heal up. Still talking to Steinbacher about jaw surgery to replace the Yaremchuk implant and address the sleep apnea.

 

[Deleted member 16834]

Update here: had surgery with Eppley two days ago and flew home same day. He removed the malar implants, shaved them down, and replaced them. He also re-did the lower eyelid incision on the right side to tighten it and pull up the lower lid that was still retracted a bit even after the repair with AJ Amadi here in Seattle.

I'm still swollen, obviously, but all looks well. Eppley revised the implants to completely eliminated the infraorbital portion and size down the remaining portions--i.e., the ogee projection and the lateral projection of the zygos. Even with swelling, it looks MUCH better without the infraorbital augmentation and reduced ogee curve. (My mother said, "I wouldn't have told you before, but it looked unnatural and it's much better now.") I will say, though, that I told Eppley to reduce the lateral projection of the implants and I'm having a hard time telling the difference. Obviously I'll wait until the swelling goes down, but my hunch is that they'll still be a bit wider than I would prefer. We'll see. I knew it would be tough to give a surgeon instructions on how to revise a custom implant during surgery, when I'll be asleep and can't comment on what he's doing. Based on how the right eye looks so far, I think Eppley nailed it and it's going to be virtually identical to the left eye (which looks perfect). Hopefully I don't come to eat those words.

Like I said, I flew back the same day as surgery (about ten hours after I got out) so I could get home before swelling peaked. The five hour flight sucked because I was still loopy from the anesthesia. (The anesthesia doc was great, BTW--first time I've been under general where I couldn't tell that my throat had been intubated afterwards.) Even 56 hours post-op, there isn't THAT much swelling--the left side, where Eppley didn't need to revise the eye, is a little spongy, and both sides have swelling around the lower cheeks/jowls from the intraoral incisions. The right side is MUCH more swollen because those lower eyelid incisions really make your face blow up, but even that is going away quickly. (I forgot how these surgeries are a cycle of waking up in the morning with TONS of swelling, the swelling going down during the day, then waking up with more swelling--but slightly less than the day before--until it's gone away completely. So you look rough in the morning and pretty good in the evening for a week or two.) Haven't needed the percocets he prescribed.

Also--Eppley actually found the plastic versions of my implants and we drew on those during the preop as a guide for him to use during surgery. (ImplanTech sends a hard plastic version of the implants along with the silicone ones, and Eppley saves them for a few years--he showed me this big box of hundreds of malar implants and we were able to find mine.)

So, all in all a great experience with results looking on-point, even if the lateral projection still winds up a bit too wide. Eppley has some minuses to go along with his many plusses, and they've been discussed here a lot, but I'll add that I really enjoy working with him. He's friendly, not egocentric at all, listens, and follows up (he gave me a call the day after surgery to check in). It never seemed to bother him that I wanted to revise his design and he genuinely listened to my input when we discussed the changes I wanted during preop.

One last thing worth mentioning--he wasn't able to put screws into the implants when he put them back in. Because we eliminated all the infraorbital support, the implants sat really high in the pockets and he couldn't get access through intraoral incisions to place screws (i.e., the implants sort of went up and back in relation to the incisions). But he didn't think there would be a problem with movement.

I'll keep the thread updated as I heal up. Still talking to Steinbacher about jaw surgery to replace the Yaremchuk implant and address the sleep apnea.

Bravo this is amazing . Why don’t you consult with proven Euro surgeons for jaw surgery if you have the money? Alfaro/raffaini are both on the Mount Rushmore of bimax. Can’t see myself going to steinbacher if I had the money

 

[Anchor_Ship]

Hopefully all goes well

 

[Deleted member 7098]

Still talking to Steinbacher about jaw surgery to replace the Yaremchuk implant and address the sleep apnea.

do you actually have sleep apnea, have you done a sleep study ?
what made you want to remove the implant and go for jaw-surgery instead? especially with such a great result like yours.

feels like you have a much more predictable out-come and more room for change with implants and less of a chance to get botched, than if you go for jaw surgery.

good convalescence.

 

[Deleted member 3679]

Update here: had surgery with Eppley two days ago and flew home same day. He removed the malar implants, shaved them down, and replaced them. He also re-did the lower eyelid incision on the right side to tighten it and pull up the lower lid that was still retracted a bit even after the repair with AJ Amadi here in Seattle.

I'm still swollen, obviously, but all looks well. Eppley revised the implants to completely eliminated the infraorbital portion and size down the remaining portions--i.e., the ogee projection and the lateral projection of the zygos. Even with swelling, it looks MUCH better without the infraorbital augmentation and reduced ogee curve. (My mother said, "I wouldn't have told you before, but it looked unnatural and it's much better now.") I will say, though, that I told Eppley to reduce the lateral projection of the implants and I'm having a hard time telling the difference. Obviously I'll wait until the swelling goes down, but my hunch is that they'll still be a bit wider than I would prefer. We'll see. I knew it would be tough to give a surgeon instructions on how to revise a custom implant during surgery, when I'll be asleep and can't comment on what he's doing. Based on how the right eye looks so far, I think Eppley nailed it and it's going to be virtually identical to the left eye (which looks perfect). Hopefully I don't come to eat those words.

Like I said, I flew back the same day as surgery (about ten hours after I got out) so I could get home before swelling peaked. The five hour flight sucked because I was still loopy from the anesthesia. (The anesthesia doc was great, BTW--first time I've been under general where I couldn't tell that my throat had been intubated afterwards.) Even 56 hours post-op, there isn't THAT much swelling--the left side, where Eppley didn't need to revise the eye, is a little spongy, and both sides have swelling around the lower cheeks/jowls from the intraoral incisions. The right side is MUCH more swollen because those lower eyelid incisions really make your face blow up, but even that is going away quickly. (I forgot how these surgeries are a cycle of waking up in the morning with TONS of swelling, the swelling going down during the day, then waking up with more swelling--but slightly less than the day before--until it's gone away completely. So you look rough in the morning and pretty good in the evening for a week or two.) Haven't needed the percocets he prescribed.

Also--Eppley actually found the plastic versions of my implants and we drew on those during the preop as a guide for him to use during surgery. (ImplanTech sends a hard plastic version of the implants along with the silicone ones, and Eppley saves them for a few years--he showed me this big box of hundreds of malar implants and we were able to find mine.)

So, all in all a great experience with results looking on-point, even if the lateral projection still winds up a bit too wide. Eppley has some minuses to go along with his many plusses, and they've been discussed here a lot, but I'll add that I really enjoy working with him. He's friendly, not egocentric at all, listens, and follows up (he gave me a call the day after surgery to check in). It never seemed to bother him that I wanted to revise his design and he genuinely listened to my input when we discussed the changes I wanted during preop.

One last thing worth mentioning--he wasn't able to put screws into the implants when he put them back in. Because we eliminated all the infraorbital support, the implants sat really high in the pockets and he couldn't get access through intraoral incisions to place screws (i.e., the implants sort of went up and back in relation to the incisions). But he didn't think there would be a problem with movement.

I'll keep the thread updated as I heal up. Still talking to Steinbacher about jaw surgery to replace the Yaremchuk implant and address the sleep apnea.

Nice! Glad to hear things went well, post pics whenever you feel comfortable doing so. BTW I sent you a message on IG!

 

[Win200]

Bravo this is amazing . Why don’t you consult with proven Euro surgeons for jaw surgery if you have the money? Alfaro/raffaini are both on the Mount Rushmore of bimax. Can’t see myself going to steinbacher if I had the money

No real reason other than I'd really prefer not to have to travel to Europe for surgery. And not sure if they can bill American insurance. Why wouldn't you go with Steinbacher?

 

[Win200]

do you actually have sleep apnea, have you done a sleep study ?
what made you want to remove the implant and go for jaw-surgery instead? especially with such a great result like yours.

feels like you have a much more predictable out-come and more room for change with implants and less of a chance to get botched, than if you go for jaw surgery.

good convalescence.

Yup, had a sleep study done in December.

The reason for the jaw surgery would be that it can effectively solve sleep apnea and eliminate the need for a CPAP. My sleep apnea symptoms are pretty awful and doing away with them would be lifechanging.

And I don't LOVE my implant result; my chin was a little recessed to begin with and slapping chin augmentation on top of that isn't as ideal as moving the entire jaw forward, and I think the implant is a bit too wide and really makes my face too big.

But I honestly don't know much about jaw surgery and have never considered it, so I'm open to ideas and learning more. I know there's a big focus on this board on jaw surgery, so seems like plenty of expertise here.

 

[randomvanish]

And I don't LOVE my implant result; my chin was a little recessed to begin with and slapping chin augmentation on top of that isn't as ideal as moving the entire jaw forward, and I think the implant is a bit too wide and really makes my face too big.

any other problems besides the design? have you ever feel anything wrong about nerves, soft tissue etc?

 

[CristianT]

One last thing worth mentioning--he wasn't able to put screws into the implants when he put them back in. Because we eliminated all the infraorbital support, the implants sat really high in the pockets and he couldn't get access through intraoral incisions to place screws (i.e., the implants sort of went up and back in relation to the incisions). But he didn't think there would be a problem with movement.

I think this part worries me, even though he told you not to worry about the movement you cant know what will happen in 5-10 years, and if there is friction or movement than the bone erosion will happen. I dont like this tbh.

 

[Win200]

any other problems besides the design? have you ever feel anything wrong about nerves, soft tissue etc?

Nope, no issues in those areas at all.

 

[Win200]

I think this part worries me, even though he told you not to worry about the movement you cant know what will happen in 5-10 years, and if there is friction or movement than the bone erosion will happen. I dont like this tbh.

Yeah, I thought about that, but even studies of unsecured implants show they don't settle move than 2mm. And the cheeks aren't a mobile area like a chin/jawline. I'm not terribly concerned and I understand why he wasn't able to secure them. I think a lot of the concern on this forum about bone erosion is overblown, tbh.

 

[Deleted member 3679]

Yup, had a sleep study done in December.

The reason for the jaw surgery would be that it can effectively solve sleep apnea and eliminate the need for a CPAP. My sleep apnea symptoms are pretty awful and doing away with them would be lifechanging.

And I don't LOVE my implant result; my chin was a little recessed to begin with and slapping chin augmentation on top of that isn't as ideal as moving the entire jaw forward, and I think the implant is a bit too wide and really makes my face too big.

But I honestly don't know much about jaw surgery and have never considered it, so I'm open to ideas and learning more. I know there's a big focus on this board on jaw surgery, so seems like plenty of expertise here.

Genio with bimax is better than chin implant... when I had a chin implant there was like a 'gap' between my lower lip and chin and my chin looked very pointy. After moving it forward with the DJS it looks much more balanced... you can also get ramus widening during the surgery as well.

 

[Deleted member 7098]

ramus widening

How

 

[Birdcell]

Did you get any surgeries for mandible op ?

 

[Win200]

Five day update: Most of the swelling around the cheeks is gone, and so is the swelling from the incisions that settled into my jowls. There's still puffiness in my mid-face around where the intra-oral incisions are. The lower eyelid that Eppley repaired dropped a little as the swelling died down and is still sitting a little lower than the left eye, but I'm hopeful that it won't drop any more given that the swelling is gone. As it is now, I don't think it would merit any more repair attempts to try to get it to perfectly match the left side. But we'll see as things continue to settle over the next few weeks.

All in all, looks good--but I do wish Eppley had reduced the lateral projection of the implants much more. I feel like I was pretty explicit about that and I'm not sure why he didn't do it. I really don't feel like that part of the implant was reduced at all. I supposed I could have someone in Seattle pop them out again, shave them more, and put them back--it's really not a hard procedure at all, and it just involved opening up the incisions again.

 

[Looksmax305]

Five day update: Most of the swelling around the cheeks is gone, and so is the swelling from the incisions that settled into my jowls. There's still puffiness in my mid-face around where the intra-oral incisions are. The lower eyelid that Eppley repaired dropped a little as the swelling died down and is still sitting a little lower than the left eye, but I'm hopeful that it won't drop any more given that the swelling is gone. As it is now, I don't think it would merit any more repair attempts to try to get it to perfectly match the left side. But we'll see as things continue to settle over the next few weeks.

All in all, looks good--but I do wish Eppley had reduced the lateral projection of the implants much more. I feel like I was pretty explicit about that and I'm not sure why he didn't do it. I really don't feel like that part of the implant was reduced at all. I supposed I could have someone in Seattle pop them out again, shave them more, and put them back--it's really not a hard procedure at all, and it just involved opening up the incisions again.

You very likely have BPD tho and will never be satisfied or at the very least the technology required to reach EXACTLY what you want doesn’t exist

 

[Deleted member 3679]

Five day update: Most of the swelling around the cheeks is gone, and so is the swelling from the incisions that settled into my jowls. There's still puffiness in my mid-face around where the intra-oral incisions are. The lower eyelid that Eppley repaired dropped a little as the swelling died down and is still sitting a little lower than the left eye, but I'm hopeful that it won't drop any more given that the swelling is gone. As it is now, I don't think it would merit any more repair attempts to try to get it to perfectly match the left side. But we'll see as things continue to settle over the next few weeks.

All in all, looks good--but I do wish Eppley had reduced the lateral projection of the implants much more. I feel like I was pretty explicit about that and I'm not sure why he didn't do it. I really don't feel like that part of the implant was reduced at all. I supposed I could have someone in Seattle pop them out again, shave them more, and put them back--it's really not a hard procedure at all, and it just involved opening up the incisions again.

Can you please post new pic plus CT scans if you get them?

 

[Deleted member 16834]

Meet me at the corner of Westwood and Santa Monica you cheeky bastard

 

[Win200]

You very likely have BPD tho and will never be satisfied or at the very least the technology required to reach EXACTLY what you want doesn’t exist

BPD?

 

[CristianT]

Yeah, I thought about that, but even studies of unsecured implants show they don't settle move than 2mm. And the cheeks aren't a mobile area like a chin/jawline. I'm not terribly concerned and I understand why he wasn't able to secure them. I think a lot of the concern on this forum about bone erosion is overblown, tbh.

Yes but remember you have a life as well. What happens when you sleep and then you fuss around in the bed while sleeping and you also sleep with your face at the pillow, or swim or put pressure by mistake on your face, all these things you have to take in consideration. Tbh I would never agree to not get stabilized the implants in the first place, just let it loose in your face, no bueno.

 

[Huncho02]

Five day update: Most of the swelling around the cheeks is gone, and so is the swelling from the incisions that settled into my jowls. There's still puffiness in my mid-face around where the intra-oral incisions are. The lower eyelid that Eppley repaired dropped a little as the swelling died down and is still sitting a little lower than the left eye, but I'm hopeful that it won't drop any more given that the swelling is gone. As it is now, I don't think it would merit any more repair attempts to try to get it to perfectly match the left side. But we'll see as things continue to settle over the next few weeks.

All in all, looks good--but I do wish Eppley had reduced the lateral projection of the implants much more. I feel like I was pretty explicit about that and I'm not sure why he didn't do it. I really don't feel like that part of the implant was reduced at all. I supposed I could have someone in Seattle pop them out again, shave them more, and put them back--it's really not a hard procedure at all, and it just involved opening up the incisions again.

At this point, I would just get them removed and go back to fillers so you have control of the projection you want… If you feel comfortable can you send pictures just to see how it differs from the previous ones?

 

[Danish_Retard]

BPD?

I think he meant BDD, body dysmorphic disorder.

At some point, you need to become content with your face. We don't have the technology to improve a face much more than what you have already done, and at this point what you're changing largely has no influence on your SMV or halo effect.

 

[Win200]

At this point, I would just get them removed and go back to fillers so you have control of the projection you want… If you feel comfortable can you send pictures just to see how it differs from the previous ones?

I think that's what I'm going to do. And removal is easy--any surgeon in Seattle can do it, especially since they're not screwed in. I think I'll want someone to suture the cheeks to the bone, though, to prevent sagging.

 

[xanny]

I think that's what I'm going to do. And removal is easy--any surgeon in Seattle can do it, especially since they're not screwed in. I think I'll want someone to suture the cheeks to the bone, though, to prevent sagging.

Would be the best tbh, good luck man!

 

[Win200]

Picture time! I'm eight days post-op today and feel pretty stoked about how well I've healed. The right lower eyelid keeps moving around but is sitting higher up today, so maybe I was premature in thinking Eppley didn't pull off a good repair. You'll see that the lateral projection is essentially unchanged (ugh), but the undereye support was removed and it looks a million times better.

Also, Eppley put 1cc of Restalyne into each upper eye area during surgery using a canula, and it's pretty lumpy--see the pic with my eyes angled down. Restalyne takes a long time to settle so I'm reserving judgment, but this might not have been the best work. I'm also not sure if it's a great idea to place upper eyelid filler while a patient is laying down on an operating table, but who knows.

I'm on two hours of sleep so ignore the splotchy skin.

 

[zeek]

Picture time! I'm eight days post-op today and feel pretty stoked about how well I've healed. The right lower eyelid keeps moving around but is sitting higher up today, so maybe I was premature in thinking Eppley didn't pull off a good repair. You'll see that the lateral projection is essentially unchanged (ugh), but the undereye support was removed and it looks a million times better.

Also, Eppley put 1cc of Restalyne into each upper eye area during surgery using a canula, and it's pretty lumpy--see the pic with my eyes angled down. Restalyne takes a long time to settle so I'm reserving judgment, but this might not have been the best work. I'm also not sure if it's a great idea to place upper eyelid filler while a patient is laying down on an operating table, but who knows.

I'm on two hours of sleep so ignore the splotchy skin.

The tear trough area looks much better, good improvement already. I think your lateral projection looks good tbh.

Fat is better than filler in the upper eyes, restalyne is water loving so it can swell and filler tends to migrate especially in areas with movement, maybe it will settle but if not, you can dissolve it and do fat for more natural and long lasting results.
Just might be an iterative process with fat.

Fat Grafting for Recontouring Sunken Upper Eyelids With... : Annals of Plastic Surgery

ce of a patented medical device, the MAFT-GUN, on 34 patients who had sunken upper eyelids and multiple folds. Each delivered fat parcel was accurately and consistently maintained at 1/240 mL during placement. Follow-up was regularly performed with photography for comparison. Results...

journals.lww.com