Custom Midface Implant

Q: Dr. Eppley, I wanted to share these pictures to check if they would match the custom midface implant design. His face shares similar orbital vector and eye shape to mine. These faces are projected directly below the eyes. I prefer the look where the projection is high in the midface and hollows in the lower cheek segment giving an chiseled athletic look. I have seen many cheek implant results online where the lower cheek was filled and the upper cheek was left hollow giving the patient a chubby cheek appearance. 

In regards to the implant would the given dimensions be suitable for this look? My infraorbital area appears very hollow even relative to my recessed cheeks. Ideally I’d like the result to look like the projected faces but I do understand that many factors go into the outcome. His cheek augmentation before and after is a result I’d want to avoid. He appears less masculine as the projection was lower in the cheek. His infraorbital augmentation is much better in my opinion, he looks sharper and masculine.

Like you have previously pointed out my orbital vector is negative and I’d like to augment it making it positive giving the deep set eye appearance, instead of a protruding eye appearance.

Thank you for your time and consideration.

A: Thank you for providing your pictorial examples and your goals. The reason you are having a custom midface implant is because no standard cheek implant can remotely create the type of midface augmentation that you, and every patient that has a negative orbital vector, requires. If one tries to use any standard cheek implant for your problem it would be an aesthetic disaster. Also most standard cheek implants are really made for women. While they are also routinely used in men, I find they are often aesthetically not optimal as what makes most male cheeks look better is a different zone of augmentation than that of the female. To no surprise male and female midface aesthetics and beauty are different. Most men do not want the ‘apple cheek’ look that some females want, they want a high malar augmentation result.

I am very well aware of your midface aesthetic needs and those will certainly be an integral concept in your custom midface implant design.

Dr. Barry Eppley

Indianapolis, Indiana