Q: Dear Dr. Eppley, I’m writing to you in regards to plastic surgery options. You were recommended to me as a highly qualified professional. I’m a 24 year old and I wish to transform my face for it to be more balanced and more aesthetic in general. Enclosed please find pictures for my face from various angles and a picture that I did in Photoshop which outlines how I would like my face to look. Is this realistic? Here are things that concern me by order of importance:
1) Jaw/chin is too prominent, protruding and simply too large. I would like bit smaller jaw and chin, making my face look more compact, yet remaining sharp and angular.
2) Cheek bones. As you see, mine are quite flat. Cheek implants would probably benefit here.
3)Nosejob – make my nose more prominent and fill the radix.
4) Eyebrow transplant
I would like to know my facial surgery options. This is very important for me so I would kindly ask you to provide me with a professional and honest opinion.
Thank you in advance.
A: Thank you for sending your pictures. As you have already done a nice job with Photoshop on your face, and I think all those changes are both possible and realistic, my task is to comment on how to accomplish those potential changes.
The reduction in the chin is of a horizontal nature. There are two ways to accomplish that task, either a setback genioplasty or an open submental burring reduction. I would feel more confident with the open submental approach so there are no irregular bony edges and an excess soft tissues can be excised and tightened. That is done from an under the chin (submental) incision. The other alternative is to do a setback chin osteotomy with the possible need of a submental tuck-up later is needed.
I agree about the need for cheek enhancement and stronger cheek bones using implants would be beneficial, particularly to balance out the stronger chin. (a ying and yang effect if you will)
Your ‘deficient’ nose is part of the overall flatter or less well developed midface. A dorsal augmentation rhinoplasty, in combination with cheek augmentation, would put the middle third of the face in better balance with your jawline. The real debate here is what material tio use to build-up the nose. My prerference would be your own cartilage.
Eyebrow hair transplants are the only other choice besides tattooing for improving congenitally deficient eyebrow hair density.
Dr. Barry Eppley