Dr. Eppley, For midface augmentation, should I choose paranasal filler (my maxilla is quite forward, my midface is flat and doesn’t point forward as you see in my picture) and cheek filler, or should I get an implant? The second question: how do I change my eye shape? As you see, I got strong dark circles and they are round if you look from the front, do I need infraorbital rim implants to get rid of the circles and more almond eyes (this male model squint look) or can I use filler (upper eye lid for hood look and under the eye for the circles and almond look). Thanks and kind regards.
A: The use of injectable fillers, injectable fat or implants for midface augmentation are all possible treatment options, each with their own well known advantages and disadvantages. But as a young person the best long-term approach is to have custom facial implants made for a permanent and more controlled facial shape change. Fillers and fat do not produce the same type of augmented facial look and are only going to be temporary. Eye shape change will require a lateral canthoplasty to deround the eye.
Dr. Barry Eppley