For what you are trying to accomplish and the extent of the facial volume you seek, only implants can reliably achieve the end result not cartilage grafts. It is hard to argue with the exactness and fit of custom made facial implants.
Dear MDLA27, I do not agree with the current surgical plan and diagnosis. I would not consider doing the endoscopic brow lift procedure on you as your brows are in a good position and while you have some excess eyelid skin this can be removed simply with an upper lid blepharoplasty. I agree that a rhinoplasty to refine your nose would help soften your features if that is what you desire however I do not see any need for a nose implant. Refining the tip and osteotomies would provide a very nice result without an implant. A chin implant with sub-mental liposuction would bring better balance to your profile. If indeed your intent is to feminize your features then the chin augmentation should be done carefully to add some projection for balance without masculinizing your face. Y Best regards, Michael V. Elam, M.D.
I'm not sure that I agree with the plan that you have suggested. I think your brows are in a good position and if you're trying to feminize your appearance, I would have you consider an upper eyelid surgery to remove some of the excess skin and show more of your lids. I would also recommend a rhinoplasty to refine and narrow your nose but do not see the purpose of placement of silicone implants. Similarly, strengthening your chin will masculinize it in my opinion.
My best advice to you would be to seek several opinions before proceeding. Consider your options carefully. Good luck and enjoy your results.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery,
Beverly Hills, California
Thank you for your pictures and question. After careful examination of your pictures, I don't believe you should have a forehead lift. For a man, your eyebrows are in good position. I do believe a strong chin implant will help you the most and possibly rhinoplasty to refine, but yet maintain a masculine nose and profile. The other thing I would add would be submental liposuction to better define your jawline and submental region.
Best of luck to you!
There are several features in your face that need modification to achieve your goals. I do not think brow lift is one of them. Your brow are in excellent position, maybe even a little high for a male.
Adding fat to your forehead and cheeks is a good idea.
What I think would make a significant improvement is a rhinoplasty with dorsal augmentation with autologous tissue (tissue from your own body). I try to avoid implants in the nose if possible. I have used several tissue types for augmentation including cartilage, fat, fascia, bone or a combination depending on each individual case.
With regard to your chin, I would like to know you occlusion (how your teeth come together) and maybe get an X-ray. Implants is an option, but many other options are available.
I hope that was helpful
When it comes to building up your nasal profile you should use diced cartilage wrapped into a fascial envelop. This is the industry standard. Sillicone grafts in the nose inevitably fail and become loose. You also need chin augmentation. The fact that your surgeon carves silicone implants to customize them to you is not novel as when silicone implants were all that we had to choose from, we all shaved them down to customize them to your needs. Please make a consultation to discuss further details.
Hi, from the photos your brows are the appropriate aesthetic position and shape for a softer, more feminine look. The cheeks are very flat (concave) anteriorly (in the front) and the chin is very weak which combine to create an oval shaped face. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. IMHO, fat transfer is far less reliable than a dermal filler or a facial implant.
Creating a straighter slope or forehead angle may balance the forehead but will not make the face softer and more feminine. You may want to consider hair transplants to lower the frontal hairline into the proper aesthetic position instead. I'd also like to point out that any Brow Lift (I have performed many) will require incisions within the hair which is significantly receded in your particular case.
Hope this helps.
The eyebrow position is normal, and a browlift is not necessary. A rhinoplasty procedure can address building up the bridge of the nose, narrowing the tip, and narrowing the bridge line. A chin implant can be inserted to give added projection to the chin to help with facial balance and proportions, especially with respect to the side profile. Chin implants are composed of Silastic, and are pre-manufactured in a large variety of sizes and shapes which fits most patients anatomy. They can also be custom carved when there is asymmetry or unique anatomy presented. For many examples and more information, please see the link and the video below
Thank you for the photos and questions and at a consultation aided by digital photography and your input you will be able to see potential results with your face before stepping into the operating room. That way you will be fully informed what is and what is not possible. So see some experts in your area that use this technique rather then guess what you might look like after.
I agree with the recommendation to perform upper eyelid surgery to open up your eyes. A small chin implant will help taper your frontal view and laterally to give you better balance in the profile of your chin nose forehead. Taking down some of the upper orbital ridge especially towards the center and adding cheek prominence can also help. The use of silicone or cartilage will depend on the goals of the changes. There is some overlap with materials used, but there are also limitations too. Good luck