Thoughts on New Custom Cheekbone & Mandible Implants

[madcap88]

Hey @CristianT, my implants are medpor. I didn't want to go with silicone because of the bone erosion and unwanted movement I have heard of.

 

[Wallenberg]

Good luck with bone erosion. I talked this past two weeks with 2 guys and both of them experienced bone erosion because of stupid silicone material. OP, i hope you are aware of this.

Bone erosion should be limited and I'm not sure if it is limited to silicone.

 

[madcap88]

Sounds very good. I appreciate that you are willing to share your experience with us.

I had a consultation with Dr. Y. It was a quite short consultation but Dr. Y was nice and approachable in that consultation. At this point, I think I will go with Dr. Y to get a jaw implant.

Hey @Wallenberg I updated my post and added some additional info that you may find helpful.

 

[eyebagcel]

Hey @Wallenberg , the surgery went excellent. Surgery day proved Dr. Y's expertise and his staff's high level of care. They were very good at answering any questions and concerns I had prior to surgery that day, and were very accomodating in terms of payment (Memorial Day (the day before surgery) messed up how much I could have in-hand at the time of surgery - they were fine charging my card later that day during surgery). The overnight nurse went above and beyond - I asked for half a million things and they delivered on every one.

In terms of recovery, be prepared for more swelling than you can imagine. When I looked at myself in the mirror the night after I couldn't believe how swollen my face was, words can not describe. I came back to Dr. Y about 2 days later and he removed both the tape which holds the face to reduce swelling, as well as the stitches around my eyes (malar implants) and chin area. YOU MUST ice all areas of your face as much as you can or swelling (which is more than you can image) will stay longer than you ever want. I STRONGLY recommend getting Eye mask Ice packs, Full-face Ice packs, and a face wraparound belt which holds icepacks in place so you can place exactly where you need. I'll cycle through the packs with extras in the freezer so I never lose the opportunity to reduce swelling. Dr. Y says after first couple days icing won't make a difference - I disagree on this, I instantly see the difference nearly 2 weeks after I take ice off after a session. I'm also taking Arnica, Bromelain, and Vitamin C to help swelling and recovery.

Now, in terms of result - I am obviously still VERY swollen. However, considering swelling I can already see Dr. Y may have nailed exactly what I was going for. I can tell given the overall change in my facial shape (I wanted to eliminate the 'roundness' of my face, Dr. Y absolutely did that) and add definition similiar to my references (Mahfud, Rodriguez), Dr. Y nailed that too it seems. Its been 12 days since the surgery, and the areas you would expect to be the most swollen (i.e. malar area, jaw angles, jawline, etc.) are the most swollen. With malar implant swelling, the swelling also extends down to the submalar region (due to gravity as Dr. Y mentioned) - so its hard to visually isolate what swelling is around the implant itself. The infraorbital rim part of my malar implant has also provided me a slight additional positive canthal tilt, which I actually kinda wanted from eye surgery (so that was convenient, since an actual eye surgery wasn't worth the degree of change I was seeking there. My eyes are already pretty damn good). Basically, I look in the mirror and think "If only the implants were a notch smaller" and then immediately think "Thats obviously swelling - its impossible to have the aesthetic result only 12 days after surgery. In fact, they state 6 months is standard".

So far, very impressed by Dr. Y and his staff. When swelling goes down, I'm sure I will be nearly 100% satisfied. Theres no way the perceived size including swelling only 12 days post-surgery is in range of the result / size post-swelling.

the canthal tilt change is interesting but Im thinking that could be because of the swelling and not the implant itself since I’ve never heard anyone else getting that kind of change from an infraorbital implant. only time will tell ig

 

[madcap88]

the canthal tilt change is interesting but Im thinking that could be because of the swelling and not the implant itself since I’ve never heard anyone else getting that kind of change from an infraorbital implant. only time will tell ig

Yea, thats what I thought. Though, Dr. Y did mention that it would adjust where my bottom eyelid sits - I forget why exactly. Guess time will tell.

 

[CristianT]

Hey @CristianT, my implants are medpor. I didn't want to go with silicone because of the bone erosion and unwanted movement I have heard of.

Even worse medpor, unfortunately.

 

[Wallenberg]

To put this into perspective the statement that jaw implant bone erosion occurs implies an active inflammatory bone destructive process - which does not occur. All facial implants, like all body implants including breast implants, create the biologic reaction of tissue adaptation around the implant. This is a normal process that the misinformed interpret erroneously as ‘bone erosion’. It is better turned ‘passive settling’ which means the implant is associated with a pattern or imprint on the bone which is the body’s way of relieving the pressure from an object that is naturally not meant to be there. This may be a millimeter or two of the implant settling into the bone. There may even be bone growth around the edges of the implant up onto the implant. This is a self-limited process and is most commonly associated with smaller facial implants, most commonly standard chin implants. This is not a biologic process that is usually seen in much larger implants like wrap around jawline implants or skull implants - probably because the larger size of the implant distributes the pressure of tissue displacement over a broader surface area.

Jaw Implant Bone Erosion - Plastic Surgeon | Dr. Barry L. Eppley, MD

Facial implant bone erosion is better referred to biologically as implant settling due to passive pressure release.

www.eppleyplasticsurgery.com

 

[Wallenberg]

View attachment 1730932View attachment 1730933View attachment 1730930

Only time I’ve seen significant bone erosion. And these were from off the shelf implants. They were never fixated and slight mobile because of it. They also poorly contoured to the underlying bony anatomy.

Seems that bone erosion isn't a big deal when discussing custom implants.

I will next get a CT scan of my face. Finally getting a jaw implant feels good.

 

[madcap88]

Yea @Wallenberg , I really don't think it is. I did ask Dr. Y about this, and he said in all of his years its never been an issue. I haven't heard of surgeons speaking of bone erosion as a problem. I think the main risk with implants is just getting the design right. Most of the bad results I've seen are from off-the-shelf implants (non-custom) or from surgeons who allow the patient to steer the design process (which we have no business doing, we don't have surgeon-level expertise). I think its a no-brainer that the only choice is custom, is saving an extra $3 - 6k really worth it if theres a high chance it won't fit right? Your already paying how much, right? Thats my opinion.

 

[Wallenberg]

Yea @Wallenberg , I really don't think it is. I did ask Dr. Y about this, and he said in all of his years its never been an issue. I haven't heard of surgeons speaking of bone erosion as a problem. I think the main risk with implants is just getting the design right. Most of the bad results I've seen are from off-the-shelf implants (non-custom) or from surgeons who allow the patient to steer the design process (which we have no business doing, we don't have surgeon-level expertise). Thats my opinion.

What did Dr. Y think about medpor vs silicone?

 

[madcap88]

What did Dr. Y think about medpor vs silicone?

@Wallenberg He mentioned that he has seen cases with silicone where the implant moves from it's initial location a bit. Hes also seen cases where patients regret going with silicone because they loved the design and wanted it to be 'permanent' without going through another procedure/recovery process. He mentioned some other things that related to 'bone erosion' I believe, but I do not fully recall. Dr. Y isn't some undercover embassador for Medpor so hes speaking from many years of experience. He also mentioned how earlier-on he let patients have more of a say, and they always came back with regret on their design amendments.

All that said, I do see how going with medpor may be a gamble given its more 'permanent' nature - design is all that more critical. BUT think about this.. Dr. Y's go-to is medpor, which means for the last 20+ years (or whatever its been) hes been going with that mostly. So, he would not have such a high-tier reputation if he 'missed' a decent amount on the design or at all. As I was saying, I have yet to see a 'Dr. Y miss/failure' on the web anywhere.

 

[madcap88]

I’ve seen some Dr. Y designs where he gives the patient more freedom in the design process and they seem to always turn out a bit uncanny/comical. Although, I’ve also seen Dr. Y criticized for not giving the patient a few more mm’s when they asked and then later agreeing with the patient post-op that they could of used those extra mm’s

@PapiMew Well, I guess its good I urged him to do 'natural, but better' without looking 'fake or plastic'. Also, using Toni Mahfud and Mario Rodriguez as references, that should get me within range or at the right size. Those 2 guys are the ideal for my phenotype imo. I prefer Dr. Y since I know getting botched is off the table.

 

[MrRubiks]

Infras should be more horizontal, and the jaw shouldn't be that straight imo. Jaw might be a little too wide too.

 

[madcap88]

3 1/2 week update: Substantial swelling in all implant sites, especially jaw angles and cheeks (due to swelling draining down from malar implant area - creates a bloated/fat appearance). Brusing under eyearea is still present. Current state of jaw swelling creates impression that jaw width is too wide - though certain this may be swelling since the perceived effect does not match design (lining up of outer zygo edge & jaw). Paranasal implant swelling also adds to the lower cheek swelling which makes it impossible to see any malar definition / implant results there. Essentially the draining malar swelling (due to gravity) and paranasal implant-produced swelling have made my lower cheek area (both sides of nose) SUPER swollen. I do have THICK skin, so I anticipate swelling to take longer to resolve. @Wallenberg @PapiMew

MALAR/CHEEKBONES/INFRAORBITAL: Don't seem too large at all. Looked WAY too large earlier in swelling, but not anymore.

JAW/MANDIBLE: Jaw width may be a tad wide (~10% too wide), but that could be swelling. If needed will get implant shaved down by Dr. Y.

PARANASAL: Pretty good

CHIN: Chin projection not as much as desired. May be perceived effect due to swelling in other areas. Dr. Y said he can design a extension module for the implant to add more projection (anyone else familiar with this? There is SO little info out there about any of these things), IF thats needed.

Summary:
Still substantial swelling and too early to call anything. Anyone familiar with swelling timelines?

 

[Wallenberg]

Jaw being a bit too wide (10%) doesn't sound too bad. As you said, it can be swelling, so maybe it goes down. Also, I think it's better to have a slightly too wide jaw than too narrow, but everyone has different faces.

Are you otherwise happy so far @madcap88 ?

 

[madcap88]

Jaw being a bit too wide (10%) doesn't sound too bad. As you said, it can be swelling, so maybe it goes down. Also, I think it's better to have a slightly too wide jaw than too narrow, but everyone has different faces.

Are you otherwise happy so far @madcap88 ?

@Wallenberg Aside from swelling, absolutely. I would be surprised if jaw width doesn't go down around 10% over the course of recovery, especially having thick skin. Even with swelling - jawline is kickass, the square chin really makes a difference - no roundness to my lower-third anymore. Plus, in the case I need a bit of reduction, he can always shave it down a bit, and that procedure has a much shorter recovery. Also, since a module can be added for the chin I definitely will not get anything removed. No pain or anything.

 

[Wallenberg]

@Wallenberg Aside from swelling, absolutely. I would be surprised if jaw width doesn't go down around 10% over the course of recovery, especially having thick skin. Even with swelling - jawline is kickass, the square chin really makes a difference - no roundness to my lower-third anymore. Plus, in the case I need a bit of reduction, he can always shave it down a bit, and that procedure has a much shorter recovery. Also, since a module can be added for the chin I definitely will not get anything removed. No pain or anything.

Good stuff! Keep us updated.

 

[zeek]

You are still very early in healing. Two more months then judge. But keep us updated!

 

[chip]

How is everything looking? @madcap88

 

[Blackgymmax]

looked pretty good to me. dr y pretty much always gives decent results and its better to undershoot than overshoot

 

[Blackgymmax]

Jaw being a bit too wide (10%) doesn't sound too bad. As you said, it can be swelling, so maybe it goes down. Also, I think it's better to have a slightly too wide jaw than too narrow, but everyone has different faces.

Are you otherwise happy so far @madcap88 ?

no, a jaw too wide basically destroys you. too wide can basically bring you into low tier normie zone lol. looking normal but ugly is ALWAYS better than comical and over the ideal

 

[madcap88]

@chip @Wallenberg

WRAPAROUND JAW:
Been 6 1/2 weeks since surgery - jaw still a bit wider than cheekbones (i.e. bigonial width > bizygomatic width). Not sure if it is swelling, I can feel the angles and they are hard to the touch. Meeting with Dr. Y in 2 weeks to determine options, may have wraparound implant shaved down. Both gonians flare out a tad too much. Head doesn't match my body. Excessive width seriously kills my appearance. Plenty of improvement on definition and angularity, exactly what I wanted there - just TOO wide.

Additionally, one gonion (thus side of jaw) is about an inch farther out on my head and further up than the other side. This side of the jaw covers up most of my ear. Makes jaw asymmetric and look wider on both sides. This is obvious from the back of my head and when in motion. Also meeting with Dr. Y to resolve this. Not sure what happened.

CHEEKBONES / MALAR IMPLANTS:
In terms of cheekbones, midface area is too swollen for me to see them at all. Entire cheek area below implants / side of nose is too swollen and entirely hides shape of implant. Given that swelling, midface just looks extremely bloated. That may also be affecting how the jaws perceived. I'm ~11% bodyfat so its not that. Assume too early to call, and thick skin may not be helping.

CHIN, PARANASALS:
Chin looks great (no need for stacked implant at all), and the paranasals seem good too.

The Ideal Steps Forward:
Ideally I assume he can A) fix the problematic wraparound side by shaving that side of the jaw down without compromising definition/angularity. Then, B) I wait couple more months (6-8) for swelling to go down since I have thick skin, and finally C) he shaves both sides of wraparound and cheekbones down to needed / harmonious widths.

Big things here are:
1) How can the one side be fixed? (thats a surgical error I assume)
2) Can the wraparound be shaved down enough to achieve appropriate width? (~3mm?)
3) Would shaving down reduce angularity (very bad)?
4) Will shaving down jaw require shaving down of cheekbones to keep in harmony? (probably)

5) Do I have to get them replaced? Does that mean another 15-25k?
6) Due to them being medpor, does waiting to get replaced cause a big issue?

Two roads. One where shaving of implants (wraparound and malars) resolves it. OR the second, where the wraparound jaw has to be removed AND replaced, and the malars shaved down. I prefer Road 1 if that works, who wouldn't.

 

[Improver]

What's the chin width?
Also, not sure if shaving the jaw implant will solve it or just leave you with a more rounded/bloated face.
My thought is that the width your are noticing doesn't come from the implant's width, but from your masseter muscle being pushed too outwards, it happened to me too and I had to redesign the gonial angle area with a more concave shape

 

[madcap88]

What's the chin width?
Also, not sure if shaving the jaw implant will solve it or just leave you with a more rounded/bloated face.
My thought is that the width your are noticing doesn't come from the implant's width, but from your masseter muscle being pushed too outwards, it happened to me too and I had to redesign the gonial angle area with a more concave shape

 

[looksmaxxed]

implants suck. get osteotomies

 

[Improver]

@madcap88 can't see ur quoted post

 

[chip]

@chip @Wallenberg

WRAPAROUND JAW:
Been 6 1/2 weeks since surgery - jaw still a bit wider than cheekbones (i.e. bigonial width > bizygomatic width). Not sure if it is swelling, I can feel the angles and they are hard to the touch. Meeting with Dr. Y in 2 weeks to determine options, may have wraparound implant shaved down. Both gonians flare out a tad too much. Head doesn't match my body. Excessive width seriously kills my appearance. Plenty of improvement on definition and angularity, exactly what I wanted there - just TOO wide.

Additionally, one gonion (thus side of jaw) is about an inch farther out on my head and further up than the other side. This side of the jaw covers up most of my ear. Makes jaw asymmetric and look wider on both sides. This is obvious from the back of my head and when in motion. Also meeting with Dr. Y to resolve this. Not sure what happened.

CHEEKBONES / MALAR IMPLANTS:
In terms of cheekbones, midface area is too swollen for me to see them at all. Entire cheek area below implants / side of nose is too swollen and entirely hides shape of implant. Given that swelling, midface just looks extremely bloated. That may also be affecting how the jaws perceived. I'm ~11% bodyfat so its not that. Assume too early to call, and thick skin may not be helping.

CHIN, PARANASALS:
Chin looks great (no need for stacked implant at all), and the paranasals seem good too.

The Ideal Steps Forward:
Ideally I assume he can A) fix the problematic wraparound side by shaving that side of the jaw down without compromising definition/angularity. Then, B) I wait couple more months (6-8) for swelling to go down since I have thick skin, and finally C) he shaves both sides of wraparound and cheekbones down to needed / harmonious widths.

Big things here are:
1) How can the one side be fixed? (thats a surgical error I assume)
2) Can the wraparound be shaved down enough to achieve appropriate width? (~3mm?)
3) Would shaving down reduce angularity (very bad)?
4) Will shaving down jaw require shaving down of cheekbones to keep in harmony? (probably)

5) Do I have to get them replaced? Does that mean another 15-25k?
6) Due to them being medpor, does waiting to get replaced cause a big issue?

Two roads. One where shaving of implants (wraparound and malars) resolves it. OR the second, where the wraparound jaw has to be removed AND replaced, and the malars shaved down. I prefer Road 1 if that works, who wouldn't.

Swelling is probably distorting everything a ton. I also have thick skin and swelling from orthognathic surgery took a year to subside to where you couldn’t tell something was off.

Be patient and try to look at things from only an anatomical POV right now, especially before re-opening yourself up and having even more swelling. I think your cheeks will be really good.

 

[madcap88]

Swelling is probably distorting everything a ton. I also have thick skin and swelling from orthognathic surgery took a year to subside to where you couldn’t tell something was off.

Be patient and try to look at things from only an anatomical POV right now, especially before re-opening yourself up and having even more swelling. I think your cheeks will be really good.

Swelling is probably distorting everything a ton. I also have thick skin and swelling from orthognathic surgery took a year to subside to where you couldn’t tell something was off.

Be patient and try to look at things from only an anatomical POV right now, especially before re-opening yourself up and having even more swelling. I think your cheeks will be really good.

What's the chin width?
Also, not sure if shaving the jaw implant will solve it or just leave you with a more rounded/bloated face.
My thought is that the width your are noticing doesn't come from the implant's width, but from your masseter muscle being pushed too outwards, it happened to me too and I had to redesign the gonial angle area with a more concave shape

@Improver Chin width is 29.4mm. Not sure about that concavity, since that one side is the side that is substantially farther out than the other. Its not swelling because its hard, plus its shifted up further than other side. Wondering if that side is too far out on design and should have been closer to the 8.8mm of other side - it's also further out along cheekbone.

Doesn't seem like the fact that there's more soft tissue/muscle in jaw than cheekbone area was even factored into design. Frustrated because I had discussion after discussion with Dr. Y and he urged the bizygomatic width would indeed be larger (which it's not at all). The current bigonial width is wider than my top facial third as well, really not good. Not sure if Dr. Y is even the one who designs because all the questions and discussions we had dont seem to be factored in. Dr. Y seems so quick to get the patient to stop talking, because hes so convinced he knows everything without even speaking or confirming with you. I mean, cant he just say an extra 2 sentences, why is that SO hard for him? Plus, it seems he may have designed jaw as if I was largely deficient - I wasnt recessed or anything, just needed angularity & definition.

@chip Yea, my guts telling me cheeks will be great. But the structural issue with the one side of jaw must be fixed - wondering how that may affect how cheekbones harmonize with current design. Dont believe jaw sidd issue is swelling. Anyways, my only 2 flaws (as confirmed by pro. raters) is slightly narrowing lower 3rd (which wraparound resolves) and undereye flatness (which infraorbital of cheekbone implants resolve) - so cant wait for this all to be straight.

BELOW are additional images of design.

 

[Improver]

@Improver Chin width is 29.4mm. Not sure about that concavity, since that one side is the side that is substantially farther out than the other. Its not swelling because its hard, plus its shifted up further than other side.

Doesn't seem like the fact that there's more soft tissue/muscle in jaw than cheekbone area was even factored into design. Frustrated because I had discussion after discussion with Dr. Y and he urged the bizygomatic width would indeed be larger (which it's not at all). The current bigonial width is wider than my top facial third as well, really not good. Not sure if Dr. Y is even the one who designs because all the questions and discussions we had dont seem to be factored in. Dr. Y seems so quick to get the patient to stop talking, because hes so convinced he knows everything without even speaking or confirming with you. I mean, cant he just say an extra 2 sentences, why is that SO hard for him? Plus, it seems he may have designed jaw as if I was largely deficient - I wasnt recessed or anything, just needed angularity & definition.

@chip Yea, my guts telling me cheeks will be great. But the structural issue with the one side of jaw must be fixed. Dont believe its swelling. Anyways, my only 2 flaws (as confirmed by pro. raters) is slightly narrowing lower 3rd (which wraparound resolves) and undereye flatness (which infraorbital of cheekbone implants resolve) - so cant wait for this all to be straight.

You probably have some swelling left but not more than 10% of it by 6 weeks, so it should decrease a bit more. About the asymmetry, it could be several things imo: malposition, asymmetric design, swelling, muscle spam post recent surgery, etc
Is the left side the bigger one?

 

[madcap88]

You probably have some swelling left but not more than 10% of it by 6 weeks, so it should decrease a bit more. About the asymmetry, it could be several things imo: malposition, asymmetric design, swelling, muscle spam post recent surgery, etc
Is the left side the bigger one?

It's my left side. On the design (from front view) the side that's 10mm+ of projection.

Yea, so I'm not sure less than 10% reduction by swelling is gonna bring the jaw width where it needs to be. I'm thinking they made an error during surgery OR he overestimated on the design. I noticed it within a week after the surgery, and waited to see if it resolved (which it didnt).

Dont think I should have to pay for an error he made during surgery or subpar design given he said it wouldn't after I discussed with him multiple times.

 

[Wallenberg]

Can you post your jaw? Maybe eyes covered or only the jaw without forehead and eyes?

 

[MrRubiks]

Hey @CristianT, my implants are medpor. I didn't want to go with silicone because of the bone erosion and unwanted movement I have heard of.

Smart tbh

 

[MrRubiks]

Bone erosion should be limited and I'm not sure if it is limited to silicone.

From what I've seen, bone resorption from silicone implants has no cap. It seems to continue indefinitely. By contrast, PEEK causes no bone resorption. It's also stronger, and it has no step-off.

 

[madcap88]

Can you post your jaw? Maybe eyes covered or only the jaw without forehead and eyes?

@Wallenberg

Here's a picture. Camera distortion stretches face length and reduces width. Not representative of actual size unfortunately.

 

[Wallenberg]

@Wallenberg

Here's a picture. Camera distortion stretches face length and reduces width. Not representative of actual size unfortunately.

View attachment 1784691

The right side looks good; the left is a bit too wide. Care to post a similar before pic?

 

[chip]

@Wallenberg

Here's a picture. Camera distortion stretches face length and reduces width. Not representative of actual size unfortunately.

View attachment 1784691

The malar implants are going to look really good. I do agree the jaw is too wide but the asymmetry doesn’t look abnormal, at least in this pic.

 

[Wallenberg]

The malar implants are going to look really good. I do agree the jaw is too wide but the asymmetry doesn’t look abnormal, at least in this pic.

Yeah, to be honest, it's not that bad. In real life / in motion, it doesn't look as bad. Of course, it's not optimal, but it's not a horrible result, IMO.

 

[madcap88]

Yeah, to be honest, it's not that bad. In real life / in motion, it doesn't look as bad. Of course, it's not optimal, but it's not a horrible result, IMO.

@Wallenberg Yea, that wider side is the side I was referring to earlier that from back of head it's obvious. (Think phone mirrored image) Also, there's a before in beginning of thread

So, does it seem width could come down with the swelling? If it was further in than the zygos it'd be great. If not, wondering if shaving down or replacing wraparound is best route.

@chip Yea, I can see the ogee curve whenever lights are directly above. Agree those are likely gonna be great. Just shame about the jaw width.

 

[chip]

@Wallenberg Yea, that wider side is the side I was referring to earlier that from back of head it's obvious. (Think phone mirrored image) Also, there's a before in beginning of thread

So, does it seem width could come down with the swelling? If it was further in than the zygos it'd be great. If not, wondering if shaving down or replacing wraparound is best route.

@chip Yea, I can see the ogee curve whenever lights are directly above. Agree those are likely gonna be great. Just shame about the jaw width.

On the bright side, it’s a much better scenario to have an unsatisfactory jaw implant than malar implants. The soft tissue responds much better to a removal/revision, should you entertain that option.

 

[madcap88]

On the bright side, it’s a much better scenario to have an unsatisfactory jaw implant than malar implants. The soft tissue responds much better to a removal/revision, should you entertain that option.

@chip Any thoughts on Chin Width? Anything else besides the excessive width in gonial area?

Also @Wallenberg here's another before pic.
.

 

[chip]

@chip Any thoughts on Chin Width? Anything else besides the excessive width in gonial area?

Also @Wallenberg here's another before pic.
.View attachment 1784726

I was going to say, the chin looks narrow in comparison to the jaw width. I’d say the biggest factor for telling if the jaw is too wide is it if looks wrong in comparison to your neck.

 

[MrRubiks]

@Wallenberg

Here's a picture. Camera distortion stretches face length and reduces width. Not representative of actual size unfortunately.

View attachment 1784691

Difficult to determine symmetry with so many anatomical landmarks obscured.

 

[madcap88]

I was going to say, the chin looks narrow in comparison to the jaw width. I’d say the biggest factor for telling if the jaw is too wide is it if looks wrong in comparison to your neck.

Yea, definitely a bit too wide for neck. Was considering in case of revision having Chin Width increased with reducing jaw width.

@Wallenberg Another before

 

[madcap88]

@Wallenberg Any thoughts on improvement for a revision?

 

[zeek]

From what I've seen, bone resorption from silicone implants has no cap. It seems to continue indefinitely. By contrast, PEEK causes no bone resorption. It's also stronger, and it has no step-off.

You are retarded. Every implant will cause an imprint.

 

[Birdcell]

Imagine paying for cheekbones when you could have been born chechen

 

[madcap88]

45 angle post pics. Malar curve and prominence more visible.

 

[Erik-Jón]

Fuck bro your ascend so hard and mog my incel ass, fuck bro I’m proud of ya

 

[Wallenberg]

@Wallenberg Any thoughts on improvement for a revision?

It depends on your budget and how willing you are to get it revised. I would be happy with your results, albeit the left side isn't optimal.

 

[madcap88]

It depends on your budget and how willing you are to get it revised. I would be happy with your results, albeit the left side isn't optimal.

@Wallenberg $$ is not an issue. Yes, the left side is too wide. Plus, even with that matching, both sides could be less wide.

I don't know if Chin width increase would be needed if the jaw width is brought down. Wondering if Dr. Y would discount it since he messed up.

So nothing else to modify outside widths in your opinion? @Wallenberg