Customized Cheek/jaw Implants and Chin Shortening - Boston, MA

Hi everyone! I was born with a really flat face...

Hi everyone!

I was born with a really flat face that had significant asymmetry and I've had some unsuccessful surgery with non-customized implants and fat injections. I had no idea that custom implants even existed up until a few years ago and then I'd already undergone surgery.

Correcting a flat face with asymmetry is probably one of the hardest things you can do but last year I decided to finally try to make things right once and for all!

I booked a consult with Dr. Y in December last year and we took a CT scan of my skull. I also showed some old pictures before any implants were put in and it was a relief to finally have a surgeon confirm and understand the problems. I had already made my own before/after simulation of what I wanted before I came in, so we got to the point pretty quickly. I think that knowing what you want is key when you start communicating with the surgeon and the pictures helped me show the goals I have. Surgeons are not mindreaders and you can't expect them to "see what you see".

Right now I have a lot of asymmetry, the jaw implants are different in shape/position (one square and one rounded), my midface looks bulky, malar area is too flat (I have a combined submalar/malar implant put in) and the chin is a bit too long with annoying lumps of fat/skin grafts that stick out. I also have a flat orbital area with sagging lower lids so Dr Y is not exactly in for treat.

I hate the idea of another surgery so crossing fingers this will finally be the last one!

I would advice anyone who is interested in implants to consider going customized before "off the shelf"-type and I also think that injecting a buttload of fat in a face that lacks proper bone structure doesn't give a good look. A small amount of fat gives a youthful look and it needs to be there to cover up the implants but fat alone can NOT replace lack of facial bone. I also think skin type plays a role, where a person with very thin skin might benefit from adding more fat, my skin is pretty thick so the submalarshell + fat just made me look puffy at best. I think female faces should have more fat/softness then male faces but not to the point where you look like an overblown, shapeless pillow!

I will update more as we get closer to my surgery and can also post my implant design if anyone is interested?

Pics showing eye problem

Here are some pics showing my lack of under eye support. When I showed these to Dr Y his comment was "well this explains everything" which made me both relieved and angry because I've been consulting plastic surgeons since 18 and also dentists/orthos and not once was i told that I had some major facial development issues. Bone structure is EVERYTHING as far as facial beauty goes and this can't be masked with lifting tissue or injecting fat as things will start sagging down the road. Mouth breathing can really ruin a face and I remember when I was 15 years old and started feeling something was wrong with my face as my classmates had wide smiles, no dark circles and chubby faces while I had already developed nasolabial folds, narrow smile, constant headaches and massive dark circles on a very flat face = classic traits of mouth breathing.

Inspo pictures

Apart from the simulation I did of my own face , I showed these pictures to Dr Y to describe what I want. She has nice defined cheekbones that still looks feminine and soft, a defined jaw, and overall a feminine but strong bone structure with nice facial balance. I also love how her eyes are almond shaped, horizontally long and rest beautifully on the cheekbones :)

New CT scan date

Hi everyone,

I haven't updated in a while as I've been busy with studying and working so I'm chiming in tonight: There was a problem with the quality my CT scan that was made and Dr Y couldn't work on it properly so we are doing a new one next week and I'm crossing fingers and toes it will work out this time.

I'm starting to get a bit nervous as things are closing in but I feel so determined to get things straight once and for all. I've been sad and angry that I didn't get myofunctional therapy/braces/Le Fort double jaw surgery all those years ago but that probably wouldn't have helped with my facial asymmetry and right sided orbital hypoplasia either so I'm trying to focus on here and now.

The first doctor who injected filler in my cheeks told me I literally had NO bone in my face so no wonder things are sagging at this point! I came a cross a picture of Carmen Dellorifice and she has the perfect bone structure with an amazing curve in oblique view because of how projected her mid face is. This is how good you can look as 70+ if you have strong bone - no sagging for her! She's the worlds oldest supermodel and still looks fantastic.

Wish me luck and I hope I can update you with my customized implant design soon!

Tomorrow it is!

Been relaxing in Boston for a few days and tomorrow is The Big Day! I would lie if I said I wasnt nervous, but honestly not as much as I thought I would be. I will post my design after surgery as Ive been trying to stay away from thinking about it and risk getting even more nervous. Wish me luck tomorrow:)

A short update :)

Just got back home from my final postop appointment where I got the stitches out. Ive had a temporary stitch in both eyes holding them together since surgery so been basically half blind uptil now. I was nervous about how it would look and almost didnt dare to ask for the mirror but when I saw the result it was over expected. My eyes are SO MUCH better! I got so surprised and started crying because Ive had this eye asymmetry since forever and never felt happy about wearing eye makeup because of how they looked. Dr Y really made his best to make them look as the girl pictured and now they are more almond shaped and much more symmetric :) his fellow said they might change during healing but i will tape them every single day if I have to , to make them stay this way! I will post a before and after of the eyes and also my design as promised but for now Im going to enjoy this evening! Its so much emotions that come out when you have had surgeries going wrong and problems not resolving that it is overwhelming. I cant wait to wear eye makeup for the first time and see what it looks like.

Eyes B/A


Hi everyone,

I've been getting messages from people asking about my results and I haven't posted anything as it is way too soon to evaluate. Some people have been negative and some positive. My current state is a definite improvement as far as symmetry and eye shape goes! The Orbital rim implant augmentation Is truly amazing and really improved the eye area a lot and should be considered by everyone with a flat midface imo. I had some annoying bumpy fat on and around my chin and I asked Dr Y to try to get rid of it completely and the although chin looks smoother but it is not completely removed. I don't think he wanted to do an intraoral incision and risk to mess up my mentalis muscle even further so my chin work was done from an external incision. I'm completely numb in the chin area still and partially in the midface but have had this before and it usually improves with time. I've been thinking whether I should have had the cheek implants done a bit shorter with more projection but I hope that my midface is swollen so that I will get a better contour after a few months. Now things are just pretty bulky in the cheek area.

If I had a more feminine face with a narrower nose I would have gone for the higher, chiseled look on the cheeks but my nose is pretty thick and my lips are full so it most likely wouldn't have suited me. The woman who made the review saying the was deformed by Dr Y had higher, smaller cheek implants put in and my honest opinion is that if she would have calmed down and waited she would have had a great end result that suited her face. It's insane and foolish to think you're seeing an end result after 2 weeks! My face have been changing shape every other day for these weeks and that's just how it works.

I'm glad I chose to proceed with the surgery and when the swelling has calmed down I'm definatly going to visit the orthodontist to discuss a palate expander or homeoblock appliance which is something everyone in my situation should consider. If that had been taken care of when I was a child, I might not have been in a carousel of surgery in the first place.

Merry Christmas! :)
Boston Plastic Surgeon

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