Do I Need Custom Facial Implants?

Q: Dr. Eppley, I’m a 27 year-old male hoping to improve my facial appearance with the use of facial implants. I have a rough idea of the kind of result I’d like to achieve and have attached pictures below of me now and a photoshopped version emulating the improvements I’d like to achieve. I have no idea whether I can use preformed implants or need to have custom facial implants made.

I’m interested in chin, jaw, forehead and orbital rim implants. I actually have no cheekbones whatsoever either forward or laterally which creates a very unusual appearance, but so far I’ve been using filler for correction.

Please let me know about how I can get these changes, estimated costs involved etc. I would really like to come to you for surgery as I know you are one of the best.

Thanks for your time and I really look forward to your response.

A: Based on your own morphing, the jawline change is absolutely that of a single piece custom wrap around jawline implant. That is the only type of jaw implant that can make a smooth jawline from the angle to the chin as you have shown. The lack of cheek and orbital rims (zygomatico-orbital deficiency) can be managed by two separate implants but a single custom made infraorbital-malar implant is the best implant to make a smooth transition all the way across the orbital rim and into the cheeks in the very thin tissue of the lower eyelids and cheek. What I notice in the forehead is increased brow bone prominence. Again a custom designed implant to achieve that change is always best since there are no preformed brow bone implants from which to choose.

I will have my assistant pass along the cost of custom implant surgery that would cover all these facial areas. It is possible to use a variety of preformed implants in most of these areas and some designs that I have used for other patients. But that is more of a piece meal approach that can be used if necessary but less than ideal for these more complex facial implant changes.

Dr. Barry Eppley

Indianapolis, Indiana