As you can tell by my pictures, I have a very tall head & long face. I'm looking into addressing this (partially) by reducing the vertical height of my chin and advancing it forward with a sliding genioplasty, perhaps combined with posterior jaw drop down implants to match up the jaw angle and the chin. However, I also have a very flat midface, and was wondering if cheek/jawbone implants could help improve this. Or should I look into having a rhinoplasty done? Thank you for your advice!
Am I a Good Candidate for Cheek/jawbone Implants?
Doctor Answers 9
Cheek augmentation, Cheek implants, Genioplasty
When a patients lower third of the face appears to be normal and they have adequed chin projection an anterior advancing genioplasty will not improve appearances.
Cheek augmentation is a better options in patients with midfacial deficiency.
Allowing hair to grow if possible will shorten the appearance of the upper third of the face would be the most reasonable approach.
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Cheek implants augment a flat malar/submalar area to create fullness and give more youthfulness to the cheek area. Jaw bone implants will give more of a square jaw and chin line.
Cheek implant augmentation
From your photos, you would benefit most from medium size malar/submalar implants to augment the deficient area around your cheekbone. This will also improve the relative proportion of your face so that your lower face would not look excessively long. I would recommend against shortening your chin/jaw and advancement sliding genioplasty because this will worsen the already deep depression below your lower lip (labiomental sulcus). Also a shorter lower face will not be in harmony with a long midface and will make you look older due to lack of adequate skeletal support for your soft tissue, especially in several years as you begin to age. In short, midface augmentation is all you need!
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Chin Osteotomy and Cheek Implants For Facial Shortening
In looking at our face, I would agree with you that vertically shortening your chin and bringing it forward would help balance the face better. You are correct in assuming that only a sliding genioplasty can accomplish those bony chin objectives. I would not recommend jaw angle implants for vertical posterior facial elongation as you already have some lateral jaw angle flare and the chin shortening may make any vertical dropping of the jaw angles unnecessary. Some increased cheek projection would also be beneficial. By pulling the cheeks and the chin forward together you will create a better effect of shortening the face by these forward projection changes. But all that being said, have some computer imaging done for each potential procedure and see how that influences how that makes your face look.
Cheek implants and possible jaw vertical reduction with or without a small implant.
Cheek implants and possible jaw vertical reduction with or without a small implant is what would give you the best result for facial proportion. I need better photos of the chin to give a proper answer.
Am I a Good Candidate for Cheek/jawbone Implants?
Aestehically speaking, the face appears elongated because the cheeks are flat. When the cheeks are more prominent the face appears more "center based" and less elongated.
For men, the ideal cheeks are narrow and more angular than in women. The vertical length, of your chin, is not the issue but the chin as seen on profile is weak. The chin can be augmented with a Chin Implant to balance the lower face.
Cheek Implants and a Chin Implant would IMHO create an aesthetic improvement in the face. Jaw Implants are problematic and as such, I do not use them but rather inject Radiesse into the Mandibular angle to create a more rugged flare to the jaw. Hope this helps. The video shows Radiesse to the Jaw and Perlane to the cheeks. Hope this helps.
Cheek Augmentation on a Male Should be Conservative
In reviewing your pictures, you do have a flat midface/cheek area below your eyes. Improving the contour of this area would improve your facial harmony, but to much added volume in this area can create a feminine appearance. I have found in males, unless they have severe volume loss in the midface areas, I prefer to use injectable fillers in the midface. This gives patients a chance to see if they like the changes. If a patient likes the change in this area, you can then consider cheek implants. The amount of volume from the fillers will also allow the surgeon to better access the best size implant for your face.
In summary, cheek augmentation should be conservative in males to prevent a feminine appearance. I prefer to use injectable fillers in males that need mild to moderate augmentation first to ensure they like the changes before moving forward with permanent cheek implants.
Based purely on your photos, your midface (cheeks) are relatively flat compared to the surface of your eyeball, nose and chin. A cheek (aka malar) implant is a reliable permanent source to augment this area and harmonize the balance with the rest of your face. Cheek implants can be made of several different materials but most commonly semi-solid silicone rubber which is inert, effective and relatively safe long term. The next step is to consult with a board certified plastic surgeon for a for in depth physical xam to confirm these findings and to formalize the surgical plan. Glad to help, @drryanstanton
Cheek implants for flat mid face
From your pictures, it does appear that you have fairly flat cheek bones, so I would say that you are a potential candidate for cheek augmentation. It is possible that rhinoplasty surgery could help to refine the appearance of your nose, but I don't think that this procedure would assist in reducing the vertical appearance of your face.
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