What Type of Facial Reshaping Procedures Do I Need To Achieve A More Chiseled Face?

Q: Dr. Eppley, Overall, my aim is to have a more chiseled face but also want it to look very natural – currently have c. 2-2.5ml of fillers- done last year and I am happy with results. Might get 2ml more fillers for minor improvements in upper cheeks and jaw. Can the fillers be dissolved pre surgery?

Only started noticing a more droopy/chubby face after I turned 30

Looking for a more sort of a makeover (but natural) from Dr Eppley, happy to consider multiple minor improvements

Unhappy with my resting face (seems tired/angry at times) and smile (which is quite unattractive – as per all my friends)

Have had multiple filler since past 4 years for tear trough. Would tear trough implants be a good long term solution? Is the insertion via lower eye lid?

What sort of cheek implant would you recommend? I have attached a pdf of a result from Real Self which i really like. Can this sort of an implant be combined with a tear trough implant?

I am also intrigued by a the full jaw + chin implant i saw on your website. What is the typical downtime post such a surgery? Is the implant placed above the masseter muscle?

Assuming I go for cheek and jaw implants, would the temples then look hollow? In my opinion, they already look hollow but i can somewhat hide this when I have longer hair. They are really exposed when I have short hair. 

Do I need ptosis surgery? Had an email exchange with an oculoplastic surgeon who said it will help for upper eyes after looking at few of my pictures. I am just scared of overcorrection in this sort of a surgery.

Rhinoplasty to reduce bulbous tip – not looking for anything significant, just a minor reduction, should look natural. If it goes well, may think of a more significant revision in a year.

Buccal fat removal? Will it help for a more chiseled look? Can you remove Buccal fat if I have a low fat body? I am aiming to reduce body fat to 15% in the next 3 to 4 months.

Double chin – This has been really bothering me since 2 years now. I visited two aestheticians regarding this, one suggested ultherapy because it was saggy skin and other suggested fat dissolving injections. I underwent ultherapy. I can see the jaw looks better now, still far away from the chiseled look I desire

Less curved/more straight eyebrows – hair transplant or any other options? An aesthetician told me Botox to lower central forehead may help, but I am not sure if that is correct, I haven’t seen/read anything about it online

Can something be done about lip asymmetry?

A:In answer to your facial reshaping questions:

1) All hyaluron-based injectable fillers can be dissolved before surgery.

2) Tear trough or infraorbital rim implants are usually inserted through a lower eyelid incision.

3) Combining a tear trough implant with a cheek implant is commonly done in my practice and is known as a custom infraorbital-malar implant.

4) All custom jawline implants, like standard jaw angle implants, are placed on top of the bone in a subperiosteal pocket underneath the masseter muscle.

5) Ptosis surgery will open up your eyes a bit. The technique used will determine how much upper load shortening is obtained. You probably just need a mullerectomy for a 1 to 2mm change.

6) Rhinoplasty surgery can help narrow a bulbous tip. Your thick skin would prevent any type of change from being too narrow or looking overdone.

7) For facial derounding/slimming you need buccal lipectomies and perioral and submental/neck liposuction.

8) Any change in the shape of your eyebrows os one of hair management strategies, not a surgical or Botox treatment.

9) Your left upper lip asymmetry is of less vermilion show on the left upper lip. To correct it that requires a vermilion advancement on that side by a few millimeters to match the right sided vermilion show.

Dr. Barry Eppley

Indianapolis, Indiana