Q: Dr. Eppley, I have some questions having to do with facial reshaping.
1. Is there a limitation in how many millimeters can one widen the cheekbones with a zygomatic osteotomy?
2. Since custom made cheek implants can be created as large as a patient desires, will the dimensions of the implants follow the dimensions of the widening result of the face or more specifically the soft tissue of it? For example, if a patient was to have inserted cheek implants that were about 5 mm wide each, would that lead to a total centimeter increase in bizygomatic width, or more and even less than that?
3. Aside from lip lifts, rhinoplasty and cheek implants are there any other effective ways to give an illusion of a shorter pupil to lips distance that appears long on a face? I was thinking that some work around the eyebrows could be a potentially good idea but I’m not sure how this could be done.
Thank you in advance.
A: Thank you for your inquiry. In answer to your facial reshaping questions:
1) Generally 5 to 7mms of out fracture of the anterior arch can be done before there becomes an obvious step-off externally.
2) In onlay custom cheek implants the overlying soft tissues generally follow on a near 1:1 basis.
3) Without seeing pictures of your face I can say what may or may not be effective in decreasing the pupil to lip distance.
Dr. Barry Eppley