Q: Dr. Eppley, I am a 25 year old male. I am interested to coming to see you for some procedures to help me get the model look. I have some areas of my face I am unhappy with. One being the width of my face (too wide) and the other being the contour of my forehead/supraorbital rim/temple/eye area. I read a method of making wide face slimmer by zygomatic osteotomy. I read bone heals itself in new position after zygoma osteotomy so I wondered is it possible to do zygoma osteotomy and shift the entire zygoma arch upwards slightly (and also inwards)? I believe this would give a good high but narrow cheekbone appearance, as I don’t want flat cheekbones.
My next problem is my forehead/eyes/temple area. My temples are very hollow and I have asymmetrical supraorbital rims. The supraorbital rims protrude which are more apparent due to hollow temples. My forehead is very backward sloping, despite it being protruding and having prominent frontal sinus area.
I had considered options of frontal brow bossing reduction and then adding custom made implant on the forehead extending from forehead to supraorbital rims or to the temples. I always wanted supraorbital rim implants because I like the look of small squinty deep set eyes. I do not want to look feminine. I have added pictures of my forehead and eyes and pictures of how I want my eyes/forehead to be. I had an endoscopic browlift as an attempt to create the model look few years ago (because the surgeon said it would create a model look) but I feel it didn’t and needs to be reversed. I can’t work out what makes male model have eyes like that? They have strong foreheads, and is it the supraorbital rim that makes them have that model look? Along with a more hooded eye, and supraorbital rims that blend into the temple area? I really would appreciate your expert advise on this because you seem to be so knowledgable on your field.
A: I think there is no question that what makes for the so called ‘male model look’ is facial skeletonization…meaning an enhancement of facial skeletal areas such as the forehead, brow bones, cheeks, chin and jawline/jaw angles. As for the forehead in general, a backward sloping forehead angulation is not desirable regardless of what degree of brow bone prominence one has or does not have. A fuller more vertical forehead shape that allows for a noticeable brow bone break is the most masculine of all forehead shapes.
A endoscopic brow lift would work exactly against this type of male look as brow elevation and retro movement of the frontal hairline, particularly in a forehead that already has a backward inclination, will usually make it more feminine appearing. You may have discovered that in your own experience.
Blending the supraprbital rim/forehead into the temporal regions would be relevant for the high anterior temporal one but for the low one or the classic zone of temporal hollowing. That is much more effectively treated by standard subfascial temporal implants.
As for the zygomatic bones/arches, I do not feel that yours is wide and there would be little benefit to try to move the bone to accomplish any external aesthetic benefit. If you want further enhancement at the anterior zygomatic or high zygomatic arch levels, that would need to be done with a custom designed implant. That would be far more effective, predictable and have a much more rapid recovery.
Dr. Barry Eppley
Q: Dr. Eppley, I have had some computer imaging done for some facial change that I want to make but I am not completely happy with the imaging predictions. I’m very particular of what I’m trying to go for, but I don’t even know if it’s possible. I went on facetouchup.com last night. Have you heard of it? It’s like photo shop and you can adjust any part of your face to your liking. I played around a bit with my nose and I really like the end result. I attached it on this email. If that’s not possible, I understand, but I was wondering actually, if you could tell me, if you could do absolutely anything with my nose what would you change? Also I’m not too crazy about the use jaw implants from the front view. I guess it’s one of those things that work on someone else’s face but not on mine. The main purpose of wanting a jaw and chin implants was to make my face less round more oval shaped. Do you think you can get a similar result like the attached male model example?
A: Programs like Face Touchup are for fun, not for reality. You can do anything on these programs or with more sophisticated programs like Photoshop. This does not mean that it can be created surgically. Photo imaging is about communicating goals, not about guaranteeing a result or the ability to create that exact look. You are much better off considering and undergoing surgery with what may realistically happen,, nto with what you hope will happen. A plastic surgeon driving the imaging program is going to be closer to reality than any patient doing it.
I don’t think jaw angle implants are for you. You don’t have the anatomy for it to create the right effect. Your facial tissues are too thick and all those implants do is make your face fatter not slimmer. The only slimming effect that will work for your face is a vertical lengthening chin osteotomy and buccal fat removal.
One reality that you will have to accept is that your face is never going to look as refined and angular as the faces of the model images that you have shown. (aka male model look) You don’t have the right facial tissues for it. The best you can achieve is somewhere between what your face look like now and those pictures.
Dr. Barry Eppley