What Facial Reshaping Procedures Do I Need To Improve My Facial Appearance?

Q: Dr. Eppley, I am interested in facial reshaping surgery. I have attached some pictures of me. Some in fluorescent bathroom light and the others in regular day light from a window. I don’t want to try to “copy” someone’s looks , but I’d rather change my own features in order add as much harmony as possible. I think I would benefit from a nose job. However for the rest of the face things seem more complex and a lot can go wrong. That’s why going to a highly regarded surgeon such as yourself would be the optimal choice for me. 

So my problems are that even with a nose job, I’ll still be left with with a face that lacks harmony. My midface is simply way too long. I seem to have a “recessed” maxilla, with little volume leading to a thinner looking face and lack of under eye support (in my case causing the appearance of slightly bulging eyes). Realistically I would like to widen / add more volume to my face. As well as fix my eyes, to give a more upward tired lateral eye shape. I’ve read a lot about different procedures such as infraorbital rim implants, as well as orbital decompression and even just regular fillers. As for the length of the midface, I think that perhaps it could be be made to appear shorter by either a rhinoplasty combined with a lip lift or perhaps extending my chin (which seems a bit recessed) and widening my jaw. I would absolutely like a more prominent/square jaw and chin. So I’m just wondering what options would give me a wider looking face with a more defined jaw/chin as well as under eye support. 

I just need a plan or a list of recommend procedures. Something that would give me the best results. 

A: Thank you for sending your pictures. Your midface looks long, and there is some component to that perception, but it is mainly because of your other facial features. Your nose is large and protruding and your mouth area is very small. (small lip size and lip width) When you add in some mild chin and infraorbital bony deficiency, this collection of facial features makes the middle part of your face looks too dominant. This would never be approached through a LeFort 1 impaction, besides the negative impact on your upper lip-tooth relationship, because that is simply not the main issue. There are many other facial features that could be changed to put your face into better proportion. They would be the following facial rehabbing surgery procedures in order of importance:

1) Reduction rhinoplasty

2) Chin/Jawline augmentation

3) Upper and lower Lip Advancements with possible mouth widening (I usually do not like to do these two lip changes together)

4) Infraorbital- Malar Augmentation

Dr. Barry Eppley

Indianapolis, Indiana