Will A Cheekbone Reduction and Infraorbital Rim Implants Make My Face More Defined?

Q: Dear Dr. Eppley, I have a question about cheek and orbital rim implants. I have fairly wide cheek bones that I am considering reducing via osteotomy, but the frontal cheek area directly beneath my eyes seems deficient. Are there cheek implants (or fillers) that can push out this area under the eye (a slightly near the transition of the nose)? Can the results of such cheekbone implants make a wide/flat face look less wide and more defined? Also, does cheekbone reduction cause sagging skin/prejowl?

I have fairly large eyebrow ridges, which I am generally happy about, but the ridge area close to my radix is deficient compared to the prominent ridge area near my temples (I think it pushes my eyebrows up vertically near the side of the temples). Is there a way to augment the area near the radix so that it more smoothly matches the rest of my eyebrow ridge? Would the only way to do this be to have an open-scalp incision? What would be the complications of such a procedure?

A: It is common in wide cheek or zygomatic widths to have anterior infraorbital rim deficiency. This is part of the wide midface look. There are specific infraorbital-malar implants that augment this area exclusively. They come in a variety of styles and sizes although my preference is to custom carve implants out of a Gore-tex block at the time of surgery, particularly when the amount of rim/tear trough augmentation is small.

I don’t know if you would call a combined cheekbone reduction with infraorbital rim implants making the face more defined. But it will change its shape and proportions acroos the midface area to look less wide. Calling it increased facial definition is a stretch.

Building up the radic of the nose can be done with either injectable fillers or fat for a minimal or non-invasive approach or can it be bult up with either a very small implant or cartilage from an intranasal approach. A scalp incision would never be needed.

Dr. Barry Eppley

Indianapolis, Indiana