Will Custom Facial Implants Improve My Facial Imbalances?

Q: Dr. Eppley, I hope this finds you safe and well. I’m a young man who would like to look the best I possibly can and have long considered cosmetic surgery but never quite pulled the trigger. Part of it is that I’m fairly confident in my appearance to start and have worried that augmentations could end up making things worse instead of better. Still, I find myself carefully adjusting my face by how I hold my jaw or flex my cheek muscles under my eyes or pout my upper lip, not just in photos but almost constantly when I’m with other people.

In wanting to look like the best possible version of myself, I’d love your professional input, but I do have some ideas. I’ve attached 6 photos of my face in sunlight (no makeup or filters) relaxed and not biting down on my cheeks to help show you what I think could be improved. My main concern areas are the under-eyes/tear-troughs and my jawline/chin as well as balancing some facial discrepancies (mostly in these areas). I tend to trust all that Golden Phi Ratio stuff, and I’m assuming that helps guide your work as well, so the closer I can get to that, the better. I’ve considered fillers, but I think I thought implants might be more effective (and cost-effective) for what I’m looking for. Hopefully you appreciate thoroughness and this isn’t overkill, but I figured it would be most helpful for me to split comments up photo by photo since they’re all different angles.

Photo 1: Front-facing. You can see there isn’t a lot of structure beneath the eyes making me appear a little hollow and tired. This is worse on my right side with my right eye appearing to droop a bit, especially the lower lid and outer corner. My lower eyes/eyelid also have a mild bulgy kind of appearance I’d like to mitigate. The midface is somewhat flat whereas I’d prefer I looked more awake, even, and contoured. The tear troughs are rather prominent as well. You can see my left cheekbone has more structural integrity than my right; the entire right side of my face is just a little droopier overall, even that corner of my mouth is a bit lower. Also, while not super prominent here, my nasolabial folds are getting a little deep. To address all of this, I’m sure you have recommendations, but my assumptions would be a custom jawline/chin implant, cheek/orbital rim implants, and philtrum shortening/upper lip lift possibly with some filler. The overall goal being a more balanced/movie star/contoured appearance. I do definitely want to be wary of any jaw or cheekbone implants being too wide since I already have relatively close-set eyes. 

Photo 2 is a three quarter profile turned to my right. You can see my right cheekbone is a little less developed than my right and my left jawline isn’t quite as strong as my right (see Photo 4), it even manages to make my chin look slightly weaker from this angle. Again, the under-eye/orbital rim/upper cheek area could be built up more and the philtrum area is a little long. 

Photo 3 is the left side profile. Another view of how the jaw could be strengthen and cheekbone/under-eye area given more structure. 

Photo 4 is the three quarter profile turned to my left. My face is more attractive from this angle. You can see the left cheekbone and right jawline are sharper, Even so, you can see the way the lack of structure is worse beneath my right eye and how, really, all myall my features get more delicate beneath my brow bone. It suits my nose well, but everything else could be strengthened a bit so long as we keep everything well-proportioned. 

Photo 5 is the right side profile – not bad, same notes really, jaw and cheek/under-eye could be stronger. 

Thanks for taking the time to read this novel. I look forward to connecting, hearing your perspective, and learning what’s possible! 

A: Thank you for your inquiry, sending all of your pictures and detailing your facial concerns and objectives:

1) Your facial assessment is correct in that you have facial imbalances manifest as a negative orbital vector, under eye hollows with associated flatter anterior cheeks and a deep labiomental sulcus which is associated with primarily a vertically short lower chin/jawline.  Many of these facial structural symptoms people try to compensate for by facial posturing (holding the lower jaw open to elongate the face, sucking in the soft tissue below the cheeks to make the cheeks appear more evident) just as you describe yourself doing. (see attached facial vectors of deficiency)

2) These facial symptoms fundamentally come down to facial skeletal deficiencies of infraorbital-malar hypoplasia and a vertically short lower jaw.

3) What you have is very common in my experience and is treated by custom infraorbital-malar and jawline implants +/- midface defatting. (see attached imaging as one version of change)

Dr. Barry Eppley

Indianapolis, Indiana