Q: Dr. Eppley, I want to look younger and more attractive. I used to get comments that I looked so much like Angelina Jolie. I don't get those compliments anymore. One of the attached photos is me when I was younger. The other one is me now. I need some cheek sculpting to bring my now fat cheeks in more.
A: Thank you for sending your pictures. The difference between you now and when you were younger appears to be wide or 'fatter' cheeks with loss of a high cheek definition look. This could be caused by aging (falling cheek tissue) or increased fat collections in the lower cheeks with age and some potential weight gain. Careful analysis of your pictures shows that the main difference is inversion of the soft tissue cheek triangle. When younger the cheek was an upside triangle with most of the fullness up top and the apex of the triangle down below inverted inward. With time the triangle has inverted with the base of the triangle now at the bottom of the cheek (most fullness) and the top of the triangle up high over the cheek bone. (Ileast fullness) To attempt to rearrange this soft tissue triangle the following needs to be done…buccal fat pad extraction and relocation to the cheek bone (like placing an implant) or cheek fat injections and perioral (lower cheek) liposuction. In essence, add fullness over the cheek bones and remove fat below the cheek bones. Since fat changes are the crux of the facial problem it makes most sense to undergo a fat redistrbution surgery.
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.