I have a very flat face with bulgy eyes and would like to know what kind of surgeries will help give me more depth? (photos)

Question

I get extremely self conscious when standing under harsh lighting because my bulgy eyes stand out (I don’t have thyroid disease). I looked into getting cheek fillers and brow bone implant since my brow bone is very weak and extremely flat. I feel these two surgeries will help deepen my eyes to take away the bulging But I’ve also looked into orbital decompression. What should I do?

Jed H. Horowitz, MD, FACS · Answer

Hello mv0955Cheek implants are available in a range of different shapes and sizes, they are mostly customized to fit a specific facial structure. Fillers such as Juvederm Voluma, Radiesse and RestylaneLyft are great alternatives to cheek implants, also fat transfer or injection can be done.

Jonathan Kulbersh, MD · Answer

Both implants and fillers in the cheeks can create good results for patients. Both can build up the cheeks and create symmetry. You must balance the pros and cons of each procedure and do what you feel is the best decision for you.
Fillers:
Pros: No downtime Reversible Quick
Cons: Temporary More expensive in long run
Implants Pros: Permanent Great for patients with poor bone structure Less expensive overtime
Negative: Risks associated with surgery Possible infection Downtime
Hope this helps.

Jason Emer, MD · Answer

Volume and symmetry of the face created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Francis Johns, MD · Answer

Thank you for your question.I would suggest starting with fillers, they are not permanent but can give you great results with what you are trying to achieve. If you are pleased with fillers, fat grafting would be a more permanent options to help contour those areas and less invasive.

Barry L. Eppley, MD, DMD · Answer

Your approach of bringing out the recessed facial areas (brow bone and cheeks) is the appropriate one. Brow bone augmentation by a custom implant is the best and most assured method to achieve that augmentation above the eyes. Implants or fillers can be used for the cheeks. Orbital decompression is not a recommended approach as too much orbital volume is not the problem. This is a facial skeletal problem.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.   Non smiling photos of your face from the front would help in the evaluation (eyes open). From these photos, your cheeks are flat in the front, there is excess fat in front of the cheeks and the chin as well as the back portion of the jaw line is weak.  
 Following my beauty principles, 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.  Liposuction can reduce excess fat to further shape the cheeks and face.
 There are many faces that have excess fat over the cheek area which hides the "true" shape of the cheeks below.  In addition to obstructing the cheek shape, this excess fat will sag prematurely as it is pulled by gravity at an accelerated rate versus a face without excess fat in the mid face.  Removal of the excess fat, with liposuction, is key when properly shaping the cheeks with cheek implants.  I have used this in combination with cheek implant surgery for 30 years.  In my experience these procedures when combined in a face with excess fat in the mid face are extremely safe, effective and reliable in the aesthetic results they produce.
 I have performed many Chin Augmentations using chin implants for over 30 years.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).  Orbital decompression is a serious surgery that is typically reserved for exophthalmus.  Increasing bone volume around the superior orbital rim would masculinize the eye area and face....not feminize it. Hope this helps.

I have a very flat face with bulgy eyes and would like to know what kind of surgeries will help give me more depth? (photos)

Answers (6)

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