Your Questions
Your Questions
Q: Dr. Eppley, do you feel it is possible to create an aesthetic male face even with my Class 1 hypertelorism? I understand that it can be found to be an attractive feature in women (such as Jackie Kennedy), but I can’t really seem to find any examples of good looking male face with hypertelorism. Do you know of any? Thanks!
A: First degree hypertelorism, as you have been mentioned, can be attractive in females. You have mentioned Jackie Kennedy as an historic example but Uma Thurman would be a more recent illustration. When it comes to men, however, I have never heard it so described and can not think of any example where it is.
The spacing between the eyes can be improved by several facial camouflage strategies. I have not seen a side view of you so I can not say how successful they would be in your case. Building up the bridge of the nose, usually with an implant, is a classic example of decreasing the distance between the eyes. This is best done in patients that have a low or wide nasal bridge. The higher the nasal bridge, the less the eyes look far apart. In addition, widening the lower face can also help camouflage it. Cheek and jaw angle implants in particular help widen a the lower 2/3 s of the face.
Dr. Barry Eppley
Indianapolis,Indiana
Q: Dr. Eppley, I am interested in implants to correct my jaw asymmetry. My jaw angles are very asymmetric and I feel I would be more attractive if my facial asymmetry was corrected. I have always been curious about art with respect to beauty. What is beauty? I’ve concluded that beauty is not only in the eye of the beholder but also in the symmetry of the viewed. When you see a symmetric butterfly, it looks beautiful. When you see the symmetry of a supermodel, it is beauty. So this is something that I have become aware of over the years… and others have as well. In fact, there is now an iPhone app that can rate your attractiveness by measuring your symmetry… and guess what actor ranks the highest… It’s Brad Pitt. His left side of his face is exactly like his right side.
I have read your comment about not being able to reach a perfect match on anyone’s facial asymmetry, but instead improving on it. I like that realistic goal. I personally would be highly satisfied if I used a string that was measured and cut to reach from the corner of my left outer eye to the corner of my left corner back jaw (mandibular ramus) and have that string reach the same distance on the right side of my face as well. It currently does not match. But if it did, I would be a happy man. And I also understand that even if I had this result, the symmetry would not be perfect since the position of the corner jaws may be different in the 3-D x-y-z coordinate system.
A: While I have found that perfect symmetry can be difficult to achieve in facial surgery, that does not mean it is not the goal. There are different methods in trying to achieve that symmetry regardless of the location of the implants. Traditional, and still the most commonly done, method of facial implant surgery is to pick out the implants based on a more or less artistic assessment of the patient’s needs. There is no precise method of matching the implants to the underlying bone shape or knowing exactly what the outward changes will be. As unscientific as that is, it works most of the time when the patient’s facial bones are symmetric and the patient isn’t overly detailed or looking for perfection. When it comes to improving facial asymmetry, however, it is easy to see how an unexact science applied to a variable problem is prone to some degree of a persistent level of asymmetry.
To counter these issues, an ideal approach is to make custom implants off of a 3-D model. When this is economically feasible, it is easy to see why this is better than ‘eyeballing’ it.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a condition known as facial lipoatrophy. From what I have read it is type III or IV based on how my face looks. I am 24 years old and have had this look since I was a teenager. It makes me look older than I really am and I am concerned if I look this way now what I will look like in 10 or 20 years. I have high cheekbones but they are very skeletal-looking with indentations beneath them with loose skin sitting atop them. What type of surgery will make my face look more normal?
A: The look of facial lipoatrophy is easily identifiable with loss of some or nearly all subcutaneous and buccal fat over the central portion of the face. Surgery must incorporate both hard and soft tissue augmentation since the problem extends over both bone-supported and non-bone supported facial areas. One successful treatment strategy is a combination of submalar implants to fill out the upper submalar triangle and fat injections for the lower submalar triangle and the sides of the face. Temporal implants can also be used for the always present temporal hollowing which is often overlooked in the treatment of facial lipoatrophy.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I want to achieve a male-model look. I think that I have rather feminine facial features and I would like to look masculine. I was thinking about a square and a big jaw to match my high and curved forehead, a Rhinoplasty, Dimples, and high cheek bones implants. Do you think I will need anything else? I want to look handsome, a 1010 by most women scale. I don’t have a precise male model look that I thought of, but I guess I will choose the one that would naturally suit my face the most. What do you think, can we achieve it? Do I need all of the procedures I listed? Do I need any other procedures?
A: Thank you for your inquiry and sending your pictures. Let me first start off by making some general comments about structural facial surgery, particularly in men. The use of the term, ‘male model look’, really refers to creating some angularity and definition in the facial bone highlights and overall better facial balance and harmony of the features. This does not mean that one will ever look like a male model or may even be considered strikingly more handsome after such features. All plastic surgery can do is help a patient have better facial features and improve the facial foundation and the face that nature has given them. Therefore, while I understand quite clearly your objective and improvements can be made, I do not like young male face patients to have goals such as ‘male model’ or ‘I’ll be a 10’ after surgery. This is a setup for disappointment.
That being said, I will work on some computer imaging and show you what may be achieveable with a variety of procedures.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am a 20 year old male and have what I would describe as a long and narrow jaw. I am wanting to get my face/jaw to be wider and more masculine to that of a square jaw type face and understand this can be done via mandible implants? I want to know would these implants last forever as I hear a lot of stories that the implants get infected or shift. I wouldn’t want to have them for say 25 years then on the 26th year something goes wrong. I could have a wife and kids then and would be a whole new person. Are these implants successful?
A: All facial implants, including any used in the mandible, are made of synthetic materials that do not degrade or resorb. Thus the implants are permanent, will not wear out and will last the rest of one’s life. This does not mean that they can not have problems as any implant surgery in the body may have. In facial implants, the risk of infection is an early one related to the time period around implantation. Once well healed, the risk of infection is very rare. Shifting of one’s implants can occur over time but can be completely prevented if the implant is secured into position by the use of bone screws. Well placed, well secured facial implants have a very low risk of any long-term problems. To be most successful, like any plastic surgery, choose your surgeon carefully as implantation technique has the greatest influence on long-term prevention of potential problems.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a short midface and we had previously discussed using cheek, paranasal and premaxillary implants to give me more midface projection for an improved facial look. At your suggestion, I also visited an orthodontist who advised me to have a Lefort 1 procedure because there is an issue with my tongue not having enough room in my mouth and is constantly sore from rubbing on my teeth at the right side. He says implants would not help this but a LeFort advancement would. What are your views?
A: There is no question that the best functional treatment for maxillary retrusion is a LeFort (maxillary) advancement. This is the complete opposite of a cosmetic camouflage approach using multiple facial implants. These two approaches are diametric methods for treating midfacial retrusion. The key decision about a maxillary osteotomy approach at your age is whether you are committed for the necessary presurgical and postsurgical orthodontics required and that the amount of maxillary advancement that would be obtained is a minimum of 5mms, preferably 7mms. Any amount of maxillary forward movement less than 5mms would not be worth that amount of effort. It may also be possible that you would need a mandibular osteotomy setback as well to get the necessary forward movement of the maxilla. These are issues that would be known in advance through comprehensive orthognathic surgical treatment planning. Even with maxillary advancement you will still benefit by simultaneously performed cheek implants as the maxillary osteotomy moves the dental and nasal base bone but not the cheek bone.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in getting a chin implant and think I want the Medpor type. I have read about them and what there advantages and disadvantages are. They say their advantages are that tissue ingrowth decreases movement which prevents erosion of the underlying bone and permits access of the implant to the immune system, reducing the long-term risk of implant infection and rejection. They can also be carved better to solve asymmetries. Their disadvantages are that they are harder to remove, higher risk of infection in the first few weeks and are more difficult to place. Are these accurate?
A:While there are material differences between Medpor and silicone rubber (silastic) for facial implants, choosing an implant based on its material composition is findamentally flawed. What is most important are the following issues in facial implants: 1) What is the correct implant style and size for the facial skeletal problem and 2) How easy is it to place, secure and subsequently remove if need be. If you fail to achieve these first two goals in using facial implants, then it really doesn’t matter what the material composition is.
Neither implant material type and their style and size selections is right for every patient and every facial aesthetic need. The advantages and disadvantages of each material must be considered on an individual patient basis. Some of your listed advantages and disadvantages of Medpor facial implants are inaccurate such as being easy to carve and adapt to the bone site, they are actually much harder to shape and place. Medpor has no proven advantage over silicone when it comes to infection/rejection. Medpor also has many less styles and sizes of available facial implants compared to silastic facial implants.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in correcting the asymmetry of my face. The right side of it, particularly in the jaw angle area, is tilted upwards and shorter. I have read that a jaw angle implant may be able to correct this tilt.Would this implant make the right side look closer to the left and would I feel the difference? Would a cheek implant help along with the mandibular angle implant to even out the balance? I don’t want the right looking more full and balanced then the left. Would braces help fix or improve the jaw tilt/angle?
A: In the ideal correction of facial asymmetry, it rarely is just one facial area that is shorter or asymmetric. In most cases of facial asymmetry, the entire side of that face is shorter. For this reason, jaw angle and cheek implants together are often done and produce the greatest amount of facial lengthening and correction of the shorter side.
Braces change how the teeth fit together but will not change the tilt of the jawline.
The goal of facial asymmetry correction with facial implants, the most common treatment method, is to try and get the best match between the two sides as possible. While perfect symmetry is never possible, the closer the two match the better. In the spirit of that goal, it is always better to be slightly less full than too full when deciding about implant sizes.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, Hello, I am 25 years old and have had twelve IPL treatments. It has disfigured my face, somewhat like a thermage side effect. I have lost all collagen, subcutaneous tissue, and tissue and facial padding. My skin just sags, there is no elasticity or tightness or shape in my face any more, just very thin skin. Would cheek, chin, forehead, and temporal implants help bring my face back? Or can that all regenerate and grow back after time?
A: You did not say why you had the IPL treatments, for what condition, and why so many. But that issue aside, IPL does create a subcutaneous heating effect. When done enough times it is possible to cause to cause subcutaneous fat loss. You are not the first person that I have heard that has had this effect. I would wait up to a full year after the last IPL treatment to see if any regeneration of tissue substance will occur. While I would not be optimistic that it will happen, time will answer that question. If not, then the first thing to consider is injectable fat grafting, perhaps even using a stem cell-enhanced method. You should try and replace what is lost as the first approach. While facial implants are bone-based methods of facial contour augmentation, and they may be appropriate for some facial areas, I would think fat replacement first by facial fat injection. Some combination of the two may also be considered. But I would need to see some pictures of your face for further assessment to provide more detailed recommendations.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am 19 years old and very thin. But still the skin on my face is very loose. When I pull my cheek and jaw skin towards my ears, my face looks chiseled. Otherwise it looks round and slight chubby. I want to know if a facelift is good for me? If not what I can do to improve my face?
A: It would be hard to imagine under any circumstance that a facelift would be warranted on someone your age. Pulling one’s facial skin back does make everyone’s face look more defined as the bony prominences, particularly the jawline and chin, become more pronounced. But that does not mean that a facelift (neck-jowl lift) is warranted. A facelift’s primary objective and indication is for skin laxity and sagging not to make the face appear more sculpted. (although it can create that secondary effect) You are likely in need of facial procedures that provide enhancement of your facial bone prominences, such as the chin, cheeks or jaw angles. Such facial implants can help create a more defined or chiseled face. But a facelift is definitely not what you need.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, My upper jaw (maxilla) seems to be slightly recessed and the natural outward projection of maxilla is not present creating an unusually flatter profile in mid-face. My chin is also recessed but interestingly don’t have any bite problem. After extraction orthodontics(to treat crowding) the problem seems to have aggravated and now the upper teeth show way behind the upper lip and now the dental arch provides minimal support to the lip. This makes the upper lip to hang without proper base support resulting in speech problems. (lisp) I also had an unsuccessful chin surgery (implant removed 1 yr back) creating awkward tensions in chin fold area and trickier lower lip movement. Combined with above, my face is in pretty bad shape and preventing me to achieve a good speech. Kindly suggest what are the options.
A: By your description, it sounds like the fundamental problem is that of maxillary horizontal retrusion. That has been magnified by the teeth extractions for orthodontics which have pulled the anterior maxillary teeth (and the lip support) further back. It would be important to have a full facial skeletal workup on you (photographs, x-rays and dental models) to determine the viability of orthognathic surgery. (maxillary and mandibular advancement combined) That would treat the fundamental underlying problem of a deficient skeletal base. Onlay implant facial augmentation is another option (midface and chin implants) but should only be considered if the orthognathic surgical approach was either not possible to do or was too extreme an approach to go through.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I have a weak jaw in terms of width and projection, coupled with a long and narrow face. I don’t wish to get any implants into my face as this idea scares me. I believe my only option now to add width to my jaw would be dermal fillers. How many mm can dermal fillers like Radiesse and others add to the jaw. I believe I am 10-15 mm deficient in terms of the jaw. What is the maximum the best dermal filler can give in terms of width? What is the name of this filler?
A: I am afraid that the very thing that scares you is the only good option to do. While Radiesse injectable filler can be added to any area along the jawline, it would take a lot of material to create 10 to 15mms of bony augmentation. That cost alone would well exceed $10,000 to $15,000 for a result that would last at best 1 year. That cost is comparable to surgically implanting multiple jaw implants which would be permanent and last a lifetime, provided they suffered no initial complications.
Injectable fillers for bone augmentation is to provide some subtle highlights that do not justify surgery or as a trial to see if implants might be a good choice. Facial implants are for significant volume and contour change that require broad surface areas of material. Your jaw problem is better suited to the latter. Injectable fillers are not a good option for you.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Six years ago I had a mandibular implant placed as well as malar implants. I am unhappy with the end result and do not feel the result was what I requested. I think, as I did then, that a geniomandibular groove implant with extended malar implants would provide my desired results.
A: I am assuming when you say mandibular implant you are referring to a chin implant. Since you feel that a geniomandibular groove implant is better, it appears that you feel that the transition between the chin and jowl area is not a smooth or confluent one or that the jowl area needs to be more enhanced as well. Do you know what type of chin implant you have in now?
From a cheek standpoint, the desire for further malar extension suggests that either you desire more fullness out across the zygoma to the zygomatioc arch or that your desire more fullness in the submalar area suggesting more of a malar shell design. Do you know what type of malar implants you have in now?
Please send me some photographs of your face and let me know, if you can, what type of implants you have in place. A copy of your original operative note can also be very helpful as often the type of implants used are described there. Once I have this information, I can offer a more qualified response as to the best replacement facial implants for you.
Dr. Barry Eppley
Indianapolis Indiana
Q: Dr. Eppley ! My question to you is that I have a very short face. My midface is short and my ramus and lower jaw is also short which makes my face long horizontol and very short vertically. Also, my teeth of my upper jaw is way forward which is making my life miserable of having low self esteem. What type of surgery can correct this?
A: When there are jaw and teeth disharmony, one should look at the overall maxillomandibular and occlusal relatiopnships. Many times these require orthodontic and ultimately orthognathic surgical solutions. This is a path thaty should be pursued if one is young and this amount of effort can really be worth it over the long span of one’s life.
Short of major orthognathic surgery, there can be ‘camouflage’ solutions that can improve the facial skeletal balance. These are done using facial implants, usually off-the-shelf implants will work but sometimes it requires custom-designed implants. This is particularly useful in the vertically short face where the lower border of the lower jaw needs to be lengthened for which there is no way to do this without a custom implant design which is done off of a skull model made from the patient’s 3-D CT scan.
For the upper teeth protrusion, I would look into selective orthodontics. Even if you just pulled back the upper teeth only, that would make a cosmetic improvement for you and reduce the upper lip flaring.
Dr. Barry Eppley
Indianapolis Indiana
Q: I went in for a rhinoplasty consultation and, during the course of discussion, the plastic surgeon brought up the idea of combining it with a premaxillary implant. I had never heard of that type of facial implant before. I can understand that it pushes out the base of the nose but I am concerned as to what it may due to my upper lip. Does a premaxillary implant change the appearance of the upper lip in any way?
A: The premaxillary implant is one of the uncommonly used of all the facial implants. The benefit of its use comes when one’s facial profile or midface is a little recessed or retruded. With this facial skeletal pattern, the nasolabial angle is usually too acute (less than 90 degrees) and contributes to a hanging or downturned nasal tip appearance. Bringing out the nasal base can be aesthetically helpful in midfacial hypoplasia whether one is having a rhinoplasty or not. The premaxillary implant builds out the paranasal and the anterior nasal spine area using an implant which spans across the entire lower pyriform aperture region. (nasal base) This will usually result in a very mild vertical lip lengthening although that will not occur in everyone based on their anatomy. At the least, it will cause the upper part of the lip to be more full/protrusive. This will also change the nasolabial angle, the angle between the columella of the nose and the upper lip, which is the primary objective of this type of facial implant.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I am interested in getting some facial implant work done and was wondering if I can have wisdom teeth extraction done at the same time? I want to get orbital rim implants with a possible midface lift. Is there any reason why these two can not be done together? Will one potentially cause problems with the other or is it better to have them done separately, like a decreased risk of infection?
A: I see no reason why these two facial bone procedures can not be done at the same time. It is quite common to do multiple hard and soft tissue procedures of the face together. The face is tremendously well vascularized and very resistant to infection. (I didn’t say impossible just very resistant) While such a combination (facial implants and 3rd molar extraction) is unusual, it is by no means contraindicated. The hardest part is not the operation, but finding someone who is well qualified to do both at the same time.
Orbital rim augmentation and a midface lift is done from the outside through a lower blepharoplasty incision. Wisdom tooth or 3rd molar extraction is done intraorally from inside the mouth. The two areas are not anatomically contiguous and would not connect, thus ensuring no risk of oral bacterial contamination coming in contact with any implanted material. Because of this risk, the orbital/midface procedure is done first so cross-contamination from instruments does not cause any inadvertent oral bacterial inoculation on the implant.
Dr. Barry Eppley
Indianapolis Indiana
Q: Do paranasal implants any effect on the length of the upper lip? Do they lengthen the upper lip, what is common with premaxillary implants, or do the paranasal implants rather lift the upper lip a little bit? In one of your You Tube videos about Advanta PTFE facial implants you soaked these implants in an antibiotic solution before they are implanted. Would you similarly dip the Medpor implants in a antibiotic solution also? I noticed that you use both implant materials – silicone and Medpor – and you obviously know the advantages and disadvantages of both very well. I personally would prefer the Medpor implants because they permit tissue ingrowth. But I often hear that Medpor implants are virtually unremovable once they are incorporated. Have you ever removed an incorporated Medpor implant? Is it true that it is extremely difficult to separate the periosteum from the surface of an incorporated Medpor implant?
A: Paranasal implants will not lengthen or push the lip down like a premaxillary implant. Neither will they lift the upper lip either. They merely provide fullness to the nasal base.
I soak all implanted materials in an antibiotic solution. This is particularly valuable in porous implants where bacteria can become trapped into the pores of the implant and not easily washed or rubbed off. The porous nature of the Medpor material also allows an antibiotic solution to be impregnated into the implant with vacuum infiltration or prolonged soaking.
Tissue incorporation into a facial implant is a two-edged sword. It has a benefit of providing anchoring of the implant to the bone site through tissue fixationalthough that advantage can be gained by screw fixation at the time of placement. Removal is definitely more difficult but by no means impossible, particularly for a small anteriorly located implant under the nose. It is more tedious and more tissue disruption must be done to get them out but it is not that difficult.
Dr. Barry Eppley
Indianapolis Indiana
Q: I had cheek implants 3 yrs ago which I am looking at having revised. I am tall and athletic and they are just giving me a bony gaunt look to my face which also makes my eyes appear too far apart. What I really wanted in the beginning were midface implants, but wasn’t able to make this clear with the doctor. They are screwed in and I am wondering if they can simply be reduced or shaven down? Also I have jaw implants and am not happy with the square shape that has resulted from their outcome .
A: Facial implants today come in a wide variety of styles and sizes. They are far more versatile than just augmenting the chin, cheeks or jaw angle in a single way. Frequently, I have patients come to my Indianapolis plastic surgery practice that have existing facial implants but did not end up with the result that they wanted. Communication and computer imaging is key in facial bone augmentation with implants.
Both cheek and jaw angle implants can certainly be modified, exchanged, or simply removed. The question for both areas is what is the best strategy to achieve your goals. From a cheek standpoint, you may have been more interested in submalar implants (on the underside of the cheek bone) rather than malar implants which sit on top. They create different looks. With the objective of improving a gaunt looking face, submalar augmentation is preferred. Malar implants will actually make that appearance worse. In jaw angle implants, the size may be too big or their position on the bone may be too high or too low. The style and shape of the implant can also affect how square or sharp the mandibular angle is.
Dr. Barry Eppley
Indianapolis, Indiana
Q : My jaw is asymmetrical. It is tilted and is also bigger on one side. I have read some of the articles you have written on facial asymmetry and wanted to ask you about how best to correct my problem?
A: Jaw or mandibular asymmetry is often a major cause of facial asymmetry. Often the entire side of one’s face is different if one looks for it carefully. Sometimes it is the lower face (jaw) that is the most significant part, other times the cheek, orbital, and forehead bones are equally involved and part of the problem. It is critically important to assess both sides of the face from top to bottom with photographs and measurements from different angles to get an accurate assessment.
In most cases of minor to moderate facial asymmetry, camouflage techniques are used. This means the use of facial implants to lengthen and broaden the smaller and flatter facial prominences. These are good options for jaw angles and cheeks. Chin asymmetry is often better done with osteotomies where the bone can be differentially lengthened between the vertically shorter and normal sides. Soft tissue deficiencies can be simultaneously improved by fat injections.
If significant facial asymmetry exists and one’s occlusion (bite) is very tilted, another consideration is orthognathic surgery. In younger patients this may be a better option if one is prepared to go through several years of preparatory orthodontics and then jaw surgery to directly treat the primary bone, differential bone growth.
Dr. Barry Eppley
Q: Can facial implants help to fill in a cheek region, where collagen injections have been beneficial? I have a large depressed scar from dermabrasion and laser treatments on an acne scarred region of my face. I would be glad to email pictures of the region to assist in the answer.
A: Facial implants work by pushing out from the underlying bone on the overlying soft tissue. This how they create more highlights or volume to specific facial bony prominences. While a facial implant can be placed anywhere on the facial bones, they work best on convex or flat surfaces such as the chin, cheeks, and jaw angles.
The treatment of most depressed scars would be either some form of surgical scar revision (cut out and re-closure) or skin resurfacing. In some select cases, such as yours, actually filling in the underlying soft tissue helps flatten the outer appearance of the scarred area. Injectable fillers can work well for that type of depressed scar but they are not permanent and must be repeated.
You have correctly pointed a very uncommon but potentially beneficial approach to depressed cheek scars. Having proven that soft tissue expansion makes the scar look better, it is insightful to ask about whether a cheek implant can create the same effect. Since the cheek bone is convex, an implant will definitely push outward on the skin, helping flatten a depressed scar. I have done such an approach twice in my Indianapolis plastic surgery practice and it can work well as you have surmised.
The key to the successful use of an implant for a depressed cheek scar is two-fold. The acne or traumatic scars must be directly over the prominence of the cheekbone to get the most benefit from the underlying push of the implant. And you must consider the opposite cheek prominence as well from the perspective of balance. (one-sided or both sides for cheek augmentation)
Dr. Barry Eppley
Everyone knows the phrase…’beauty is skin deep but ugly goes to the bone’. While commonly said, this phrase is only partially correct. Beauty is also bone deep as the outward appearance of the face begins down at this foundational level. How the face looks at the outside has a lot to do with how it is shaped on the inside. Any forensic scientist can attest to it. Many have seen on TV shows how an unidentified corpse’s face is ‘rebuilt’ with clay layers on top of the skull and facial bones based on established soft tissue measurements. Like a roof on a house, the outer appearance of the face is highly influenced by the shape of the bone underneath it.
Treating facial bone problems has a long history in plastic surgery. Since World War I, when trench warfare created a large number of severe facial injuries (sticking your head up out of a trench was usually not a good idea), plastic surgeons have been rebuilding, rearranging, and enhancing facial bones. Today’s plastic surgeons pay particular attention in cosmetic surgery to how the skin, fat and muscle of the face redrapes over the bones, knowing full well its influence on the final shape. Whether it is a facelift, nose job,or making one’s face more masculine, being aware of and changing the shape of the bone can lead to a better balanced and more attractive face.
Facial bone changes can be done by building the bone up with synthetic implants, or in some cases, actually moving select facial bones themselves. A remarkable array of changes in the forehead, nose, cheeks, midface, lower jaw and chin are now possible.
Dr. Barry Eppley, board-certified plastic surgeon of Indianapolis, takes you down deep inside the face on a tour of its palpable architecture. Learn how many of the commonly known, and some less commonly known, cosmetic facial bone procedures work and help make for more beautiful faces.