How Can My Facial Shape Be Improved?

Q: Dr. Eppley, Hello. My overall goals are to figure out the actual cause of my concerns with my face and figure out the best possible path forward for a natural healthier look and my best overall self but not to a point where I look like a completely different person. I wish to correct poor under eye support, scleral show and negative eye hooding, nasal labial folds and possibly a recessed maxilla, excessive buccal fat since birth thats purely genetic, a large platysma muscle due to low hyoid, thin and downturned lips, and a soft jaw + also potentially getting botox to allow atrophy to occur in the masseter muscle and create a less bulky face look.

A:Thank you for your inquiry and sending your pictures. Your facial problem is fairly straightforward from a diagnostic standpoint. It is a structural issue where your entire mid face is recessed compared to the upper and lower thirds of the face (brow bone and chin projections). Ideally you should have a LeFort one advancement osteotomy followed by secondary infraorbital-malar implant augmentations for total correction of the issue.

The first place to start is to get a maxillofacial consultation to evaluate the potential for upper jaw advancement. Total midface implant augmentation should only be considered if it is determined by a surgeon or you that you do not desire to go through the initial upper jaw advancement surgery.

Barry Eppley

Plastic Surgeon