Your Questions

Q: Dr. Eppley,  I am interested in chin, cheek and jaw augmentation. Like others, I am looking for exceptionally square, strong and masculine jawline to bring my facial aesthetics to the next level. I already have a fairly low body fat percentage (around 7-8%) but have always had slight TMJ on my right side and for as long as I can remember wanted to really strengthen my face.

Would I be a good candidate for a jaw, cheek, chin augmentation, and/or rhinoplasty to strengthen and balance my face? Or should I address the slight TMJ issue first? Which procedure or combination of the aforementioned would lead to the highly coveted male model facial look? I’ve attached a photo with the front and both sides of my face as well as a goal photo for reference.

A: I have done some imaging looking at rhinoplasty, cheek, and total jaw augmentation for your review. You have a good face for these type of changes because your face is already skeletonized, just disproportionate. The jawline change will require a custom wrap around jawline implant. Whether this would achieve the male model look that you desire is open to  one’s interpretation

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, regarding cheek implants, what sort of augmentation produces the male model look and you have written that the ‘male model look’ is a vague term, denoting a wide spectrum of shapes. So let me use Johnny Depp as an example of what I envision ad the male model cheek look that I want. There is a distinctive and characterful line that runs around the side of the face and down to the chin. From my perspective it seems like for a cheek implant to create this characteristic look it would need to focus augmentation on the lateral and oblique portions of the cheek. This, is it possible for a custom cheek implant to create this lateral augmentation of the zygomatic arch?

A: When it comes to the male model cheek implants look, Johnny Depp is one of the most classic examples of the look men are seeking. You have described what creates that specific cheek look and as you may be well aware, there is no standard off-the-shelf cheek implant that is really designed to create that look. While one has to have the right midface soft tissue anatomy for a cheek implant to create this effect (thin), no currently designed cheek implant augments the lateral edge of the zygomatic arch and comes forward anteriorly into the submalar region and onto the maxilla. Malar shell and submalar implants exist and are often used to try to create this effect but rarely create that exact cheek look. A custom or semi-custom approach to the design of cheek implants is the most likely method of at least creating the correct amount and location of the bone augmentation.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, regarding jaw implants is it not true that the large masseter muscle goes a very long way to creating the characteristic model look that patients are seeking? If bony anatomy is not the only factor does this not mean that a patient will fail to achieve an authentic looking result, seeing as the implant augments bony anatomy.

A: The concept of the male model look as it relates to the jawline is a variable one that does not have a specific look per se. While it is about a strong and well defined jawline, the front to back angulation of its inferior border and the height and flare of the jaw angles can be quite variable. I have been provided many desired male model jawline pictures from young men which have many variations.

While an exact male model jawline escapes an exact anatomic description, what is not unclear is that it is created by the bony shape of the mandible. While the masseter muscle can be very thick, it is rounded and lacks any defined or sharp edges. It creates bulk and not definition. It is only relevant in how thick it is as well as the thickness of the overlying subcutaneous fat. These tissue thicknesses can obscure any well defined bony shape or implant augmentative effect of the jawline.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am interested in jaw implants to give me a more defined jawline. I can see from your computer imaging that adding the chin implant to the jaw angle implants really does make a difference. I have a couple questions. Are the implants silicone? Do the size and type of the implants determine how chiseled my face would look? I’m trying to get as close to the ‘male model’ look as possible. I’m not sure if any other procedures would make as much of a difference as these.

A: Chin and jaw angle implants (jaw implants) are made of either Medpor or silicone material and I have used both extensively. However I much prefer silicone because implants made of this material can inserted much easier, shaped intraoperatively much better if needed and are far easier to revise/remove if needed. A good saying about silicone facial implants is…easy in, easy out and easy back in if needed.

The size and the shape of the implants play a major role in the look of the final jawline result, provided one has a fairly lean facial look to start. The thicker the overlying soft tissues are, the less defined the outline of the implants becomes.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am a 52 year old white male 5'9″, 165 pounds. I have had a hair transplant and ears pinned back in 2002 and nose job way back in the in mid '80s. I have a very strict diet and workout extensively and have developed a very msucular physique, particularly for someone my age. I am concerned with my face as I am interested in male model look. What do you think could be done to make my face more aesthetically pleasing, proportional, etc. more in line with a male model type of look? I am very curious to see a computer projection of your proposed procedures. Thank you.

A: The first thing that I observe is that you have a body physique and msucular definition (to your credit) but the face doesn’t match it. While age never helps any face, your facial proportions and skeletal structure is not as robust/proportioned/chiseled as that of your body. Thus there is a mismatch and I can see why this has become an area of interest to you.

When it comes to the so-called male model look, what that means is defined facial skeletal structures or highlights of the facial triangle, the cheek, jaw angles and chin. Augmenting these three areas is what is usually done to create a more defined masculine facial structure. While your chin has reasonable projection, your jawline and face is narrow. I have done some imaging based on jaw angle augmentation, cheek implants and a square chin implant. None of your pictures are really great for imaging due to their quality, angles, lighting and facial expressions but at least they give a general idea of the effect. Be aware that computer imaging is really just a point of discussion and communication of the desired effects and reflects only one variation of the potential effects. There are magnitudes of potential change and this first set is just a starting point.

When it comes to your eyebrows, you have all of the issues that must be considered for any male browlift patient. Because of the absence of a hairline, none of the traditional browllift approaches can be used. (through the scalp) Thus most men need an upper eyelid approach (transpalpebral) with release of the medial muscle around the nerves to get sosme inner lift and relaxation of the glabellar musculature and a lateral brow lift using an endotine device. The ‘below the brow’ approach, which by necessity must be done in most men, only produces a modest brow elevation. But that usually turns out to be a good thing as one of the most unnatural and peculair looks in a man is an over elevated browlift. (e.g., Kenny Rogers, Bruce Jenner)

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m going to ask you a question you probably heard 10000 times. What procedures do I need to perform in order to get “the male model look” and look handsome?  I think(I may be wrong) I need: Skull Reshaping, Cheek Augmentation, Chin Advancement, cheek and chin;jaw/mandibular Implants,  nose rhinoplasty; lip reduction; Neck Contouring; I’ve attached a few photos of me. My face looks fat. That’s because i have about 20 pounds of excess fat. 

A: You are correct in assuming that I have been asked that question a lot….and have subsequently done a lot of male facial sculpting surgery. In getting a better balanced and more defined facial shape in a male, there is a list of procedures to consider most of whom you have mentioned. But each face is different and therefore has different needs to improve its proportions and get closer to a more sculpted look. There is also the issue of priority and the associated cost to do them so making the proper diagnosis as to the anatomic problems is extremely important in surgical procedure selection.

Your most glaring anatomic problem is your severe lower jaw/chin deficiency. A short lower jaw makes the entire lower face both horizontally and vertically short. This is what contributes to your impression that your fat is fat…it is not. It is just that the lower 1/3 of your face is overpowered by the upper 2/3s. This is further accentuated in profile by a moderate nasal hump which makes the facial convexity worse.

Your most important procedure is to get the lower 1/3 of your face in proportion. This is beyond what a chin implant alone can do. You really need a chin osteotomy (sliding genioplasty) combined with a small square chin implant placed in front of it. Removing your nasal dorsal hump would then complement your facial profile. (see attached side profile prediction) These are the two most important procedures. Secondary consideration could also be given to cheek implants. (see attached front view prediction)

While some other procedures may be complementary, this is the foundation for helping you get closer to more of a ‘male model look’.

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: I have a few questions on creating the male model look which I have read about in a number of forums.  This will involve a number of procedures including cheek, chin, and jaw implants, facial liposuction, rhinoplasty, lipadvancement, and possibly a forehead and brow augmentation.  First, is it recommended to have all these procedures performed at the same time?  Second, is there a discount on the per procedure cost for having multiple procedures performed at the same time?

A: The male model look is about having a well defined or well chiseled look to the face. This specifically relates to facial features where the bony highlights of the face are prominent and ‘strong’. What it would take for any man’s face to achieve that look, or whether it is even possible, depends a lot on the anatomy and look of their face to start with. No everyone is going to need all the procedures that you have described. Some may just benefit from just a few of them in facial areas where they are deficient. Others may require a more complete number of available facial contouring procedures to get a better result. Each man’s face must be assessed on its own merits and must have a custom treatment plan. Some may just require a rhinoplasty and chin implant, others may require those as well as cheek and jaw angle implants and buccal fat extraction.

That being said, in the spirit of getting the best change possible, whatever procedures are deemed best should be done at the same time if possible. That is not only more efficient from a facial change and recovery standpoint but is more economically efficient as well. The main reason to ever stage such facial procedures is because of the cost or if one is uncertain as to whether a procedure(s) may be beneficial.

Dr. Barry Eppley

Indianapolis Indiana