Is It Common To Undergo Combined Custom Infraorbital-Malar and Custom Jawline Implant Surgery?

Q: Dr. Eppley, I got the opportunity to speak with several of your past patients who were referred me to last week. It was a great experience and I feel confident that I wish to move to the next step. I have two final questions for Dr. Eppley that emerged from these discussions – could you pass them along to him when you get a chance?

1. Since my cheek implants will saddle the lower orbital rims, is it possible that they can be placed intra-orally? Or do you think that these will need to be placed through the eyelid?

2. In Dr. Eppley’s experience, is doing both the jaw implant and cheek implants in a single procedure too large of an endeavor for most patients? After hearing about the extent of the swelling from past patients, I’m trying to decide between the benefits of doing both in a single procedure (cost and shared recovery time) with the enormous amount of swelling that will result from two sets of implants being placed at once. Since this will be my first cosmetic procedure, does you recommend breaking this into two procedures? Or is it common for patients who do elect to receive both jaw and cheek implants to have them placed in a single surgical session?

A: In answer to your questions:

1) When the infraorbital implant saddles the infraorbital rim, it must be placed through a lower eyelid incision. Trying to do so intraorally exponentially increases the risks of infection, implant malposition and permanent infraorbital nerve dysesthesia.  I learned long ago that the risk tradeoff is a very poor one. A cheek implant that has a significant infraorbital component is very different than one that doesn’t. 

2) It is very common for the male patient to undergo combined jawline and cheek/infraorbital-malar implants. For those that desire both facial areas it actually would be more uncommon for these two surgeries to be separated. In the end, however, one has to do what seems comfortable as after all these are purely elective surgeries as there is no medical basis for whether they should be done in one vs two stages.

Dr. Barry Eppley

Indianapolis, Indiana