Can A Custom Brow Bone Implant and Upper Blepharoplasties Be Done At The Same Time?

Q: Dr. Eppley, am middle aged male. Looking for guidance on which facial procedures for refresh and masculinization. I’d like custom silicone brow implant, full jaw implant. I have ok mid forehead brow bone, but outer area of eye socket bones is deficient (eyes are vulnerable to impacts due to lack of outer brow bone vs. socket depth). I also need brow lift (approx. 1.5mm lift of eyebrow?), modest blepharoplasty uppers (I’ve had hooded outer uppers since childhood so looking for mild upper job and fat transfer to plump up upper area below eyebrow). 

So, can you tell me if I should get brow augmentation procedure 1st, then wait a few months for my ageing skin to settle in around implant, before continuing on with brow lift and uppers bleth? I plan to get eyebrow transplant also to boost outers of eyebrows. 

Chin angle in profile is a little recessed also, is this always a separate implant to remedy? Separate from full jaw implant that is. I would need neck lift after implant, slight joweling now along with some turkey neck, mid face is still pretty good. I thought to plump up cheeks with fat transfer. I have significant jaw bone loss around teeth due to long time periodontal disease (under control/frequent visits to perio as always). 

OK, looking forward to your recommendations.

A: Thank you for you inquiry and detailing your concerns. Your supposition is correct in most cases….get the foundational work first before doing any manipulation of the aging overlying soft tissues. The swelling from the brow bone augmentation is most cases is counter productive to the soft tissue work. HOWEVER if the brow bone augmentation is limited to the tail of the brow and lateral orbital rim then it would make sense to combine that with upper blepharoplasties and browlift because these procedures are incisionally and pocket dissection synergestic and the swelling from the brow bone augmentation is not much worse than from the browlift alone. The need to separate these procedures is when a full brow bone implant is needed which requires extensive dissection from above.

Otherwise a full jaw implant includes the chin area as well.

Dr. Barry Eppley

Indianapolis, Indiana