Facial Reshaping with Cheek Implants and Chin Lengthening

Q: Dr. Eppley, I have really been mulling a facial reshaping procedure for some time. 

I am interested in getting a more heart shaped face. High, defined ogee curve – so delicate cheekbones and a V like chin. I am unclear on if I need to touch my chin at all. I am also unclear if my brow bone has anything to do with this. 

I have attached my photo and a few photos showing what shape I am aiming for. I do intend to do rhinoplasty next year but first things first. I am seeking definition that photographs well as well as looks nice in real life. 

I was really considering fillers to accomplish this look but my issue is I really want it to look like a change in structure, not fullness. I also want it to be permanent. 

Questions:

Will weight loss after surgery possibly change proportions in a negative way?

Would implants negatively affect my ability to smile?

Also, are my goals realistic at all? To be clear I know won’t like these models. Rather, is it possible to get closer to my ideal v like face shape without it looking fake? Is it possible for cosmetic surgery to achieve that facial harmony seen on actually attractive faces (as opposed to just placing features that still don’t show that balance?)

Sorry for the lengthy email. I just want to move forward and need to know if I found my solution.

A: Thank you for your inquiry. In trying achieve your facial reshaping changing the correct procedures are cheek implants, mid facial defatting (buccal lipectomies and perioral liposuction) and possible chin lengthening. (although I can not tell based on just a front view whether that is beneficial in your case or not) 

The question is not whether these procedures can be done but whether they can remotely achieve the type of facial change you are seeking given your natural facial anatomy with thicker tissues. In other words how realistic are these type of changes? There is no way to really know that answer accurately other than to say I suspect it is more unrealistic than realistic.

And to answer your two specific questions:

1) Weight loss will only help the result not adversely affect it.

2) Cheek implants will not affect your ability to smile normally.

Dr. Barry Eppley

Indianapolis, Indiana