Can Facial Implants Be Combined With A Rhinoplasty?

Q: Dr. Eppley, I know there is too much facial fat on my face but given the progress of cosmetic surgery with you as a pioneer over the last decades,  I am mailing you with interest for facial aesthetic surgery.My goal is to achieve a balanced, masculine facial structure with stronger midface and jawline proportions, while maintaining natural harmony. My bite and airway are normal, so I am looking for aesthetic contouring rather than orthognathic movement so I don’t want to go for Double jaw surgery, rotation etc .I am interested in customized facial implants (malar / paranasal / chin / jawline) and if these can be combined with rhinoplasty in one session.

Could you please give your opinion on

1. Can aesthetic cosmetic surgery be performed on me to achieve my goals.

2. Can a combination of implants be done on me to augument my upper and lower face.

 Please let me know your thoughts on the above. 

Thank you very much

A:The question is not whether you can have custom facial implants and a rhinoplasty at the same time. This combination of facial reshaping surgeries is done regularly. The more relevant question is how effective would they be in terms of achieving your goals. You have one major limiting factor in achieving any semblance of a more defined face and that is of the extensive soft tissue fullness particularly in the cheeks and lower third of the face and neck. While it is true that implant and bony augmentations can stretch out the facial tissues and help create improve definition and shape but the amount of augmentations you would need to do would be very extreme and would make your face too big and still without any desired definition. Even combined with extensive facial and neck defatting I would question whether the augmentations can overcome the soft tissue thicknesses. My concern would be, particularly of the lower third of the face and the jawline is that all you would do is just make your face full or and heavier.

That being said I don’t think the concept of jumping in and doing all of your indicated procedures would be the prudent thing to do for the reasons I have described. A more relevant plan in my opinion is to do the extensive facial and neck defatting with a rhinoplasty and a bony genioplasty and then see if further augmentations may be beneficial. At least with this approach you’re not going to make anything worse or heavier in appearance and you will likely make some facial improvements even if they might not me your ideal expectations. If there is a very positive response to these initial procedures then you can consider additional augmentations on a more favorable facial shape.

Dr. Barry Eppley

World-Renowned Plastic Surgeon