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!
Boston Plastic Surgeon

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