Q: Dr. Eppley, I have a few things I’d like to have addressed for some facial reshaping. My temporal region is a bit sunken in and causes a roundness to my face. I’m not sure if using fat grafts or a filler such as pmma is more suitable. As far as my lower third: I think it’s short and usually keep my mouth partially open to “elongate” my face to give more definition to my cheeks and jaw. My chin projection is good but it’s just short and a bit round which I’d like to square off. Also my jaw angles are high and ill defined which i’d like to correct. My cheeks have a bit of a chipmunk thing going on which I believe vertical lengthening of my lower third will help, but I believe a Buccal lipectomy will help definition substantially. I’ve attached a few pictures. Let me know what route you think would be best for what I’m trying to achieve. Any opinion on what would help give more definition and angularity to my face is more than welcome.
A: In answer to your specific facial reshaping concerns:
1) The treatment for temporal hollowing are temporal implants. They are easily placed on top of the muscle and are permanent. A second choice would be fat injections although their survival is far from assured.
2) Lengthening the entire jawline is best done by a custom jawline implant that adds vertical length from the jaw angles to the chin.
3) A buccal lipectomy will help create some submalar hollowing but will not create a complete improvement of the so called ‘chipmunk cheek’ problem.
Dr. Barry Eppley