Custom Midface Implant

Q: Dr. Eppley, I’m interested in the custom midface implant (that looks like a “mask”) you’ve recently fabricated and posted about on your Explore Plastic Surgery blog and I’m also interested in a procedure to change the width of my lips. However, I have some questions about both procedures :

For the custom midface implant :

1) Can the portion of the implant that covers the infraorbital rim area be extended to cover the zygomatic arches?

2) Can the implant design be modified to cover the sides of the maxilla at the point where a hypothetical vertical line from the pupils and a horizontal line from the sides of the alar bases meet?

3) Can the portion of the implant that covers the infraorbital rim area be extended to cover the lateral orbital rims? If this design modification is possible, how is this going to affect the lateral canthal positioning? I struggle to see how the lateral orbital rim can be sagitally advanced without altering the lateral canthus because the lateral canthus is attached to it.

As far as lip widening is concerned , from the information that I’ve gathered online I think that a lateral commisurotomy is the best way to achieve a wider mouth appearance but I was also wondering if PermaLip implants can successfully widen the lips. What do you think?

Thanks a lot !

A: In answer to your custom midface implant questions:

1) Yes

2) No

3) Yes. The lateral canthus is attached inside the lateral orbital rim, not on the outside.

4) Permalip implants will NOT create a mouth widening effect.

Dr. Barry Eppley
Indianapolis, Indiana