Facial Reshaping Surgery

Q: Dr. Eppley, after a lot of consideration I am now actually considering to do a full facial reshaping surgery. However after you see my pictures you might tell me if it is possible or if there are any limitations. I have attached a picture of the face profiles that I like. I put a picture of my actual face and a picture of my desired result. I will explain what I wish and you tell me if it’s possible or there are limitations. The whole idea of this is to bring the eyes as front as possible. 

1)Brow Bone Reduction to move back the brows as much as possible. My desired result would be where my eyebrows are in line with the eye lashes.
2) Rhinoplasty to reduce the nose as small as possible with a nice curvy shape and the top entering in line with the eye lashes.
3) Brow contouring since I will have a lot of excess skin there so I think I will be needing a brow lift.
4) I would consider reducing my forehead by 1cm or 2cm.
5) Upper lip lift (the space between the nose and the upper lip needs to be less. 
6) Chin reduction . a shorter and narrower tip,also resulting in a horizontal jaw.
7) A little facelift that would cover the old scars I have from my past facelift ten years ago.

I have studied this very carefully as to see that they are possible. I am guessing the major surgery is the brow bone reduction. 

A: Thank you for your sending all of your pictures and detailing your facial reshaping surgerygoals. In answer to your questions:

1) BROW BONE REDUCTION – you are demonstrating a maximal brow bone reduction result which wold require an osteoblastic bone flap setback technique to achieve.

2) RHINOPLASTY – The limitations of your skin thickness will prevent making your nose from becomingas small as you have imaged.

3) BROWLIFT – Your imaged results clearly show the need for a browlift with the brow bone reduction.

4) FOREHEAD REDUCTION – I assume you mean by this a frontal hairline advancement to reduce the amount of vertical forehead skin show. Whether your hairline could support this type of procedure can not be determined based on the side view pictures shown. If it did a 1 cm reduction is realistic but not a 2 cm reduction.

5) SUBNASAL LIP LIFT – That is a straightforward lip procedure of which your long upper lip can benefit.

6) CHIN RESHAPING – This type of chin change can be done by an intraoral t-shaped bony genioplasty technique or submental inferior border shave chin reshaping method

7) FACELIFT SCARS – That is the type of preauricular facelift scar I have never seen before. It can not be relocated back into the preauricular skin crease as you have illustrated. Besides not having the skin laxity to do so, even if it were possible your sideburn hair area would become aesthetically distorted.

Dr. Barry Eppley
Indianapolis, Indiana