When Can I Get Custom Infraorbital-Malar Implants After Double Jaw Surgery?

Q: Dr. Eppley, Hello, I had double jaw surgery 4 months ago. The surgery was for health reasons and was a success and has improved my sleep apnea but I am unsatisfied with the aesthetic results. I already had very little cheekbone definition but now with my upper and lower jaw moved forward, my mid face/under eye area is even more “flat” and not very defined. My maxillofacial surgeon suggested malar implants but I only want to go to the best if I am getting a cosmetic procedure. I am curious if you have experience with crafting implants for jaw surgery patients that have my complaint? Apparently it is not uncommon for men to have their upper eyes/cheekbones to be “left” behind compared to the new jaw. I am not looking for a “done” look – I want a conservative but definite cheekbone augmentation and potential fat grafting for under eye support. Is this something you can do? Also, how soon after a previous surgery can someone get implants?

A:As you have correctly surmised advancement bimaxillary surgery induces an upper midface to lower facial disproportion. It is very common today with such large jaw advancements and I have seen and treated it many times. Custom infraorbital-malar implants are the best solution given their large and complete surface area coverage of the deficiencies. That could be done at anytime after 3 months from the original surgery since all that matters is how clearly the deficiency is seen. Going through the lower eyelids to place them is a fresh surgica field that is not impacted by the scar tissue and hardware fixation below it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon