How Should I Stage My Facial Procedures?

Q: Dr. Eppley, The procedures I’m considering are: Zygomatic Reduction Osteotomy, Supraorbital Implants, Custom Jaw Angle Implants, Infraorbital Rim Implants, Bilateral Lateral Canthoplasty, Rhinoplasty, and a Bullhorn Lip Lift. I am also planning a trimax (bimax + genioplasty) separately. Some of these are major, others more subtle.

What matters most to me is figuring out how all of these work together in terms of proportion and balance. I don’t want to approach each procedure in isolation — I want to understand how they all relate to each other and how to achieve a result that is harmonious overall. I don’t have the expertise to figure that out on my own, which is why I would love to get Dr. Eppley’s take on the full picture, including how the trimax fits in.

A:Without a full assessment of yourpictures and understanding of youraesthetic objectives and concerns I can only provide a general statement about the staging of the procedures of interest

In looking at the collection of your procedures of interest the Bimax osteotomes should certainly be done first before the jaw angle implants, lip lift and rhinoplasty… as all of these will be affected by the repositioning of the maxilla. When it comes to the procedures located above the horizontal level of Lafort I osteotomy, zyg9onatic reduction osteotomies, periorbital implants and lateral canthoplasties these are not affected by the Bimax procedures directly and could be undertaken beforehand…. with the caveat that depending upon the type of movements of the Bmax procedure would that change how these procedures may be done (degree of augmentation etc)

Dr. Barry Eppley

Plastic Surgeon