Facial Reshaping Surgery

Q: Dr. Eppley, I am interested in facial reshaping surgery.I just wanted to make an enquiry about possibly having some cosmetic surgery with you in the coming months. I’ve been to a few plastic surgeons here in my country but I am having difficulty finding the right surgeon to operate on me. Having looked through your website I was very impressed with the before and after pictures of his patients and am now considering flying to America to have the surgery.

I noticed he seems to offer a lot of different types of facial implants which I am most interested in. I’m just wondering is there a limit on the amount of procedures that can be carried out at one time? I would be looking to enhance and refine several features on my face and finding a surgeon that can perform a lot of the procedures I’m interested in in Europe is very difficult.

I was hoping that you review some photographs i’ve edited myself and let me know if he thinks the result I’m looking for is possible. My goal is to install more classical features onto my face and to create a more chiseled, symmetrical bone structure with the most natural result possible so as to avoid a ‘surgery look’.

A: Thank you for your inquiry. One can have done any number of facial procedures at one time, albeit bony change or soft tissue. Even with doing a large number of procedures simultaneously, the concern is not usually looking overdone but whether enough change has occurred to satisfy the patient’s aesthetic goals. The concern about being overdone is largely relegated to anti-aging facial surgery not the type of facial reshaping surgery that younger people undergo such as you are considering. In the spirit of expectations, let me go over your morphed facial images to review what is and is not possible. You have illustrated the following changes on your face:

1) Hairline Advancement – what you have shown is reasonable although be aware that the greatest forward movement in the hairline is in the center and not in the temporal areas. Once can expect about a 1cm forward movement in males which is about what you are showing.

2) Rhinoplasty – dropping the dorsal line and shortening and rotating the tip is an achievable goal as you have shown.

3) Submalar Hollowing – removing the buccal fat pads with perioral liposuction will help but it needs to be combined with a zygomatic arch augmentation to have an effect that goes further back on your face.

4) Upper Lip Advancement – this procedure can set the vermilion-cutaneous border where you want it so that outcome can be obtained.

5) Jawline – In trying to achieve a more defined jawline (stronger chin and prominent jaw angles) you are showing the type of change that is not possible. What you have done is to vertically shorten the entire jawline and create a degree of jawline sharpness that can not be done. You just can’t vertically shorten the middle portion of the jawline like you have shown. While the squareness and greater projection of the chin is possible and well as the vertical elongation of the jaw angles, the vertical height of the middle portion of the jawline can not be changed. Either a custom three piece jawline implant (chin and two jaw angles) or a custom one-piece jawline implant (with a thin connection between the chin and jaw angles) would create a much improved definition of the jawline albeit not as vertically short or quite as sharp as you have morphed.

Dr. Barry Eppley
Indianapolis, Indiana