Posts Tagged ‘cheek implants’
Sunday, May 5th, 2013
Q: Dr. Eppley, I’m considering cheek implants to address the following problem. I have a wide round face with a flat midface and I want to avoid implants that make my face look wider or rounder. Should I go for malars without edges (so ones that only address the cheekbone) what part of the cheek contributes the most at creating forward projection? My main goal is to achieve a less wide face with more projection. Thank you so much!
A: When it comes to increasing midface projection without making the face wider, all implants have to remain inside of a vertical line drawn down from outside of the lateral orbital rim. This means the options of using orbital rim implants with small malar extensions relegated to the anterior cheekbone surface, paranasal, and premaxillary implants. These are the implants that can increase midfacial projection without creating width.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: cheek implants, dr barry eppley, indianapolis, orbital rim implants, paranasal implants, premaxillary implants
Posted in Your Questions | No Comments »
Friday, April 19th, 2013
Q: Dr. Eppley, I am interested in cheek augmentation and an African-American rhinoplasty. I have fat cheeks and I want them smaller. I also want a more refined and less fat nose. I have attached a picture of me so you can see what needs to be done.
A: Thank you for sending your picture. This one view is not the best picture to judge the result but it is helpful. I believe you are looking for a buccal lipectomy to reduce buy cialis online without a prescription the fullness under your relatively flat cheek bones. Or you could leave the buccal fat alone and augment the cheekbones which I think is a better alternative. (maybe just a little buccal fat removal. Your nose shows many of the typical ethnic features and that could be improved by an open rhinoplasty in which the nasal bridge is built up with an implant, the tip lengthened and narrowed and the nostril flaring/width reduced. I have just imaged the buccal lipectomy and the rhinoplasty.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: african-american rhinoplasty, buccal lipectomy, cheek implants, dr barry eppley, indianapolis
Posted in Your Questions | No Comments »
Sunday, April 14th, 2013
Q: Dr. Eppley, I am interested in having the following procedures done:
* Ear surgery – ear pinning + fix right ear that sits lower than left ear or fix left ear that sits higher than right ear + improve general appearance of ear cartilage
* Blepharoplasty – lower eyelid of my left eye (when I smile, it creates a prominent bag under the eye – not the case with my right eye though)
* Septoplasty – nose veers a little bit to right (possibly due to deviated septum)
* Rhinoplasty – remove slight bump & also looking to have a thinner nose
* Lip augmentation – improve general appearance
* Liposuction under chin – just to get rid of dreaded dubble chin
* Other possible procedures (if doctor recommend them): cheek implants, jaw implants and chin implant – I would like to have more masculine facial structure
Other possible procedures, if you offer them: tear trough implants, cheek lift
PICTURES:
First pic: how I actually look
Second pic: alterations I made to my face on your website (not perfect, just played around).
A: In answer to the facial procedures:
1) It is possible to raise an ear .5 to .75 cms but it is not possible to lower an ear. Ear pinning or antihelical fold setback can effectively reshape the outer ear cartilage.
2) The ‘bag’ of the left lower eyelid is hard to appreciate in your non-smiling views so I am not sure if it is a skin issue or a fat issue.
3 and 4) A septorhinoplasty is needed to straighten the nose, reduce the bump and have a thinner tip.
5) To make that amount of lip augmentation change, you would have to think about fat injections even though their survival in the lips is anything but assured.
6) Submental liposuction can be done but, more importantly, significant chin augmentation will eliminate
that concern on its own. Cheek and jaw angle implants would be complementary to the chin and, in your thin face, would make it very sculpted and angular.
7) Cheek implants will obviate the need for a cheek lift. Tear trough implants can be done to fill out the under eye hollows.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: cheek implants, chin implants, fat injections to the lips, jaw angle implants, otoplasty, septorhinoplasty
Posted in Your Questions | No Comments »
Sunday, April 14th, 2013
Q: Dr. Eppley, Are malar cheek implants considered soft tissue augmentation? Are porous implants mainly used for submalar or malar cheek implants? Do malar cheek implants sag with time if not screwed in? Sorry if I am asking so many questions! Thanks!
A: Malar or cheek implants are onlay bone implants that create overlying soft tissue augmentation by pushing from beneath it. Porous or Medpor implants are one type of facial implant (silicone being the other) that can be used for facial augmentation. The material has certain advantages and disadvantage compared
to silicone, which neither makes it better or worse than silicone in overall implant characteristics. Malar implants may shift or move from their original implanted position over time if not secured into position by screw fixation. (I would not call that sag but implant displacement)
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis, malar implants
Posted in Your Questions | No Comments »
Thursday, April 11th, 2013
Q: Dr. Eppley, I had Medpor midface rim implants placed a year ago and have had no issues so far. However, I have been considering getting a malar shell or combination submalar implant to add more contour and definition to my cheeks and midface. My only concern is that having the medpor implant would preclude this procedure. Would the cheek implants overlap the existing Medpor implant and can they be secured and screwed in over the Medpor implant? Also, would the surgery be much more difficult as I hear that Medpor implants are hard to remove, and I assume that this difficulty in removal might make it harder to create a pocket. Thank you for taking the time to read this!
A: The simple answer to your question is that is no problem on any of those issues. The silicone malar implants can be viagra online canadian pharmacy placed and overlap the Medpor material and then secured by screw fixation into place. The pocket dissection over the top of the Medpor implants is minimally more difficult and that also is not a concern.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis
Posted in Your Questions | No Comments »
Monday, March 25th, 2013
Q: Dr. Eppley, I’m now thinking I want to move forward with doing cheek implants and picked out the style of implant I want but need to know it the implant is falls into the category of small, medium or large. It’s by spectrum design and is called( malar profile ) the nominal dimensions are 5.4×3.2×0.5. But it doesn’t say if its a
medium implant or large and this is something that is important for me to know. Pls help. Thank You.
A: To help answer your question, here is the schematic on that particular cheek implant style.
| Profile Malar Implants |
 |
Catalog Number |
NOMINAL DIMENSIONS |
| A |
B |
C |
| S140-414S |
4.6 cm |
2.3 cm |
0.4 cm |
| S140-424S |
5.1 cm |
2.7 cm |
0.5 cm |
| S140-434S |
5.4 cm |
3.2 cm |
0.5 cm |
| S140-444S |
5.7 cm |
3.5 cm |
0.5 cm |
| |
|
|
|
| Sizer set 900-014 |
Designed to enhance the entire malar region, this implant features thin tapered edges and provides a smooth transition to the malar prominence. |
You can think of the four options as Small, Medium, Large, and Extra Large. Therefore what you inquiring about is S140-434S which would be considered a large implant. As you can see by this dimensional chart on cheek implants is that the thicknesses don’t differ that much but the surface area that they cover do.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis
Posted in Your Questions | No Comments »
Sunday, March 24th, 2013
Q: Dr. Eppley, I am interested in silicone malar cheek implants and wanted a dramatic look to change the shape of my flat face. I for sure want to get a medium size implant and was wondering if a 3mm falls in that category or if a 4mm is considered a medium? Thank you.
A: The determination of size is but one consideration in the selection of a cheek implant. It would be equally important to select the style or shape of cheek implant that works best for your face and could create the look you are after. But back to size, a cheek implant’s size has numerous dimensions of which thickness is but just one of them. Generally as the thickness of the implant increases so does the height and width of it as well. (total surface area that it covers) Whether a 3mm thick cheek implant would be considered a ‘medium’ would depend on what cheek implant style you are talking about. For some silicone cheek implants such as the malar shell, 3mms in thickness would be considered an intermediate sized implant.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis
Posted in Your Questions | No Comments »
Tuesday, March 12th, 2013
Q: Dr. Eppley, I am a 25 year old male and I am interested in facial cosmetic surgery. My previous history of cosmetic surgery is otoplasty, rhinoplasty and a chin implant. I would like a more balanced face and more of an oval/square shape.
Frontal/anterior view:
-Is it possible to augment more on the weaker side (jaw and cheeks) to balance asymmetry?
-On the cheekbone I would like to augment both the temporal process and the zygomatic bone, augmenting both the sides and front of the cheek bone (particular more augmentation on the right side to balance the weakness)
-On the mandible, i would like the Ramus more laterally augmented (a more square jaw) (also particularly more augmentation to balance the weakness on the right side)
-On the nose, a narrower and more defined tip
Left and right profile views:
-augmentation of the cheekbone (both the temporal process and the zygomatic bone)
-more square mandible angle
-slight de-projection of the nasal tip, lower and upper cartilage*
*Tip projection is more pronounced in the photos of the oblique smiling views.
I am sending pictures of anterior view and right oblique smiling view. If you could please send me altered photos with your expected results explaining the procedures you have added and why you feel so.
Thank you for your time and consideration
A: Thank you for your inquiry. Unfortunately the images you have sent me are inadequate for imaging. Only the front view is useful. A NON-SMILING oblique and side views are needed to get a more complete analysis.
Other issues:
1) It is not clear if the images are flipped or not. As I see them, the left side of your face is the smaller or weaker side.
2) The concept of oval and a square face are contradictory. As a male I will assume you mean more of a square facial shape is what you desire.
3) While the temporal hollows can be augmented, the bony zygomatic arch and its temporal process which lies below it can not.
4) Correction of facial asymmetries is difficult even using differently sized implants for each side. Improvement may be obtained but do not expect perfect symmetry as that will not happen.
5) Since you have already have a rhinoplasty, what was done to the tip of the nose initially? What tip changes ere already done and didn’t achieve your goals? It is now a scarred tip and a review of the previous operative note would be helpful to know what now lies underneath and whether cartilage grafts were harvested from your septum. You also have a right middle vault collapse, a step-off at the osteocartilaginous junction, significant nasal deviation and nostril retraction/asymmetry. These and the desire for tip de-projection are going to require cartilage grafts.
All this being said, I have done some imaging based on the one useful frontal view that you have provided with jaw angle, cheek and temporal implants as well as revisional rhinoplasty.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis, jaw angle implants, revisional rhinoplasty, temporal implants
Posted in Your Questions | No Comments »
Sunday, March 10th, 2013
Q: Dr. Eppley, it’s been exactly 2 months since my cheek implants were inserted and I cannot move my upper right lip & have numbness in the lower cheek area. My upper lip movement has SLIGHTLY increased since the surgery but I’m very concerned that I have permanent nerve damage or lip upper paralysis. In your experience, have you seen any cases where patients get permanent lip/facial paralysis as a result of cheek implant surgery?
A: The intraoral insertion of cheek implants is a subperiosteal pathway to the zygomatic body that lies way below where the buccal branches of the facial nerve lie in the more superficial overlying muscles. The dissection does expose the large infraorbital nerve (2nd division of the trigeminal nerve) which is a sensory nerve that exits the bone below the infraorbital rim and usually transects the small zygomatico-orbital nerve branch (sensory nerve branch) as the dissection crosses the zygomatic body. Thus it is very common to have some temporary numbness to the cheek area and even the upper lip which can take several months to resolve. It is very difficult to get motor weakness/paralysis of the buccal facial nerve branches which supply movement to the upper lip given where the nerve lies and where the deeper dissection is done. If weakness is present, it is likely due to a traction injury rather than nerve branch transection. In addition, there are numerous branches of the buccal nerve which have some cross-innervation. This means that eventual return of full lip function is assured. The return of nerve function may be slow and the fact that you are seeing some upper lip movement indicates that the recovery process is ongoing. It may take up to six months or more for complete function to return.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: cheek implants, dr barry eppley, indianapolis
Posted in Your Questions | No Comments »
Saturday, March 2nd, 2013
Q: Dr. Eppley, I have a couple of questions and I have
included a photo of me now (right side) and when I was younger (left side). I’m currently overweight and intend to lose that weight but what interests me the most is if it is possible to look like my younger and fresher self again, like the left side of the picture. I have seen surgery that make people look at least 5 years younger. Is it realistically possible to make me look like that younger me again? And if so, what are my options? What procedure would suit me best? I would say that my cheekbones, used to be wider, the cheek pads were higher, there is a lot of sagging in my cheeks. Also the area around my eyes has become hollow. The bone is more visible and my eyes look deeper placed. If I would be my own surgeon I would probably suggest to lose that weight. And maybe then turn to possible cheek implants and fillers to reduce the hollow look. I’m not sure because I’m no expert. I could be totally wrong?
A: The first question you have to asked yourself is what has changed that makes you look older. By identifying the changes then you can see what may be able to be done. Thus I would first ask you what you see. I have my thoughts but what do you identify that you see has changed? What changes do you think would make you look more refreshed? You have done that and I feel that you are totally right. That is exactly what I would recommend and what I see as beneficial…small cheek implants and fat injections to the lower eyelid hollows.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: cheek implants, dr barry eppley, fat injections to eyelid hollowing, indianapolis
Posted in Your Questions | No Comments »
|
|
|
|