How Can I Get a Non-Bloated Cheek Appearance?

Q: Dr. Eppley, I have measured that my mid face ratios and facial height to width ratio are close to ideal. I am interested in changing the features themselves and the bone structure to create a more harmonic, masculine appearance. For now, I want to focus on the bone structure. I would like to fix asymmetry and get a sharper, more angular bone structure with wide, prominent zygomatic and cheek bones. The last picture is a very crude morph of the bottom middle one, approximating an ideal result with jaw and cheek implants and several other surgeries. Based on the images and additional information, does it look like I would be a good candidate for angular-looking implants, particularly cheek and zygomatic? Or would my skin be too thick to get a sharp result, resulting in a bloated appearance?

Additional information:

– I will likely have double jaw surgery. In the pictures, my jaw is jutted forward to hide recession and simulate a possible result as a base for implants. I believe my maxilla is recessed.

– My skin is dry on my cheeks but oily on my forehead, and I rarely get cuts from shaving, if that helps indicate skin thickness.

– I often see my cheekbones in artificial lighting but not really in natural lighting. My body fat percentage is 10%.

A:I believe the fundamental question is whether IOM (infraorbital-malar) implants will create a sharper more angular midface/cheek appearance in your face? I don’t think your soft tissues are prohibitive in that regard BUT it would need to be combined with defatting below the IOM level (buccal lipectomies and perioral liposuction) to have a reasonable chance to come close to your own image changes.

Dr. Barry Eppley

World-Renowned Plastic Surgeon