Can My Flat Midface Be Fixed With A Custom Midface Mask Implant?

Q: Dr. Eppley, What would you say is the biggest change that went from when I was 16 to me right now at 23 ? Is it soft tissue (skin, fat pads) or bone changes ? I feel like my midface looks especially sunken now compare to before. I’d like to look like I did before (and ideally better) but I don’t know how. I’ll try to state my issues as clearly as possible:

-I believe that my midface looks sunken in from the front especially (and I’m talking about the lateral orbitals, infra/zygomatic region and paranasal area). I’m not sure if this is just in my head but if it’s not would I benefit from some type of lefort 3 surgery ?

-I feel like I have a long-ish midface (nose) or oversized nose and mouth relative to my midface. I’m not sure if this is an optical illusion.

-My jaw and chin seem recessed as well

Would you agree with my statements ? I would very much appreciate your insights, thank you kindly

A: Since I don’t have any reference pictures from age 16 I can’t speak to a change. All I can speak to is that now your midface is flat. (lacks horizontal projecion from the orbital rims down)

While you may be seeking a Lefort III effect that is not going to come from an osteotomy unless you have a significant Class III malocculsion…which you don’t. Thus any midface augmentation is going to need to be done by a custom midface mask implant. (see attached implant design example)

Dr. Barry Eppley

World-Renowned Plastic Surgeon