Orthognatic surgery or cheek implants and orbital rim implants first?
Doctor Answers 2
As a Maxillofacial surgeon I perform both orthognathic and facial implants surgery. If the decision has been made to have both surgeries to improve your facial aesthetics as well as facial proportions, my recommendation is to have both procedures at the same time. The reason is that the upper jaw surgery and the implant surgery utilize the same intra oral incision. If you require jaw surgery to bring your upper jaw down and forward this means that you have a midface deficiency in the vertical dimension. If the implants are place first they will almost definitely be in the way of the bone cut of the upper jaw. So if having the two surgeons work together or having the Maxillofacial surgeon do everything is not feasible you should ideally have the maxilla repositioned and healed as this will alter the relationship of the submalar fullness and hence require a smaller malar/submalar implant. If the implant is place first the maxillofacial surgeon may have to remove implants to perform his surgery.
Virtual surgical planning is available and can help your surgeon with the planning of the jaw surgery and positioning of the implants. I highly suggested this approach
best of luck