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
Q: Dr. Eppley, I am interested in a chin implant revision. I had a chin implant about six months ago and the doctor said it would look just like I wanted. Well it hasn’t and he appears to have chosen the wrong implant. What I wanted was a much wider and more square chin look and it doesn’t look that way at all. I have done some imaging on my picture to show you what chin look I am after. What is the best type of chin implant to achieve my desired look?
A: The imaged change that you desire in the width of your chin can not be made by almost any off-the-shelf preformed chin implant. Even square chin implants do not add that much width. If you look carefully, the widest part of the chin goes past a vertical line dropped down from the corners of the mouth. That is beyond the widths of most existing chin implants.
There is however a way to do it with one and only one preformed implant, the Medpor RZ extended square chin implant. It is possible to exceed its natural width because of its central connector. It is actually inserted in two separate pieces and then attached once in place. You can increase the width of the chin by a full centimeter by not snapping it together but by leaving the two pieces spaced apart and made ‘one-piece’ by only the thin bridge of the connector.
The other option is to make a one-piece design out of silicone that contains all the desired dimensions and is placed as a single piece implant. (aka custom chin implant)
Dr. Barry Eppley