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Bony Orbital Shapes in Undereye Holllowing and Negative Orbital Vectors

The shape and position of the bony orbit is one of the most important anatomic factors in the development of undereye hollowing and a negative orbital vector. While aging and soft tissue descent contribute to tear troughs, many younger patients have these features because of the underlying skeletal anatomy. The Normal (Positive Orbital Vector) In Read More…

The Role of Rib #10 in Waist Narrowing Surgery

What is the most important tib to remove/modify in waist narrowing surgery? If the goal is to achieve the greatest reduction in structural waist width, the 10th rib is the single most important rib to modify or remove. While aesthetic rib surgery has historically focused on removing the free-floating 11th and 12th ribs because they Read More…

Preoperative Testing in Shoulder Widening Surgery

Some patients before shoulder widening surgery, through either deltoid implants or clavicle lengthening techniques, may want to test how much width they desire and compare that to what the surgeries can actually achieve.. This can be done by broadening the shoulders under clothing using silicone shoulder pads which are commercially available in several designs. The Read More…

The Pleura in Rib Removal Waistline Narrowing Surgery

In rib removal surgery of the lower rib cage for a waistline narrowing effect the most feared complication is that of a pneumothorax. A pneumothorax occurs because the pleural lining of the lung is inadvertently opened or torn during surgery and is not recognized. This allows air to escape from the lungs and, if enough Read More…

The Myth of Squaring Out The Jaw Angles in Implant Designs

Why is squaring out the jaw angle in custom implant designs not a good idea? From an aesthetic and anatomic standpoint, creating a perfectly square mandibular angle with a custom jawline implant is usually not the ideal design goal. While many male patients ask for a “square jaw,” the most attractive and natural masculine jawlines Read More…

Ai -Assisted Custom Facial Implant Designs

Can I Just Let AI Design My Custom Facial Implant? The short answer is no—not yet. AI has become an exceptionally powerful tool for designing patient-specific implants, but it is still best viewed as an intelligent assistant rather than an autonomous implant designer. While AI can dramatically improve efficiency, accuracy, and consistency, the final implant Read More…

The Submental Placement Technique in Custom Wraparound Jawline Implants

The submental approach is the most common method for placement of a one-piece custom jawline implant because it provides direct access to the chin and both mandibular body regions through a single, well-hidden incision beneath the chin through which the implant is introduced. It is particularly advantageous for large wraparound implants that extend from angle Read More…

Transpalpebral Endotine Browlift in a Male Case Example

A transpalpebral Endotine brow lift is a less commonly performed variation of brow elevation in which the brow is lifted through an upper eyelid (blepharoplasty) incision rather than through scalp incisions. The Endotine device is used to secure the elevated brow tissues to the frontal bone. This technique combines an upper blepharoplasty with a direct Read More…

Female Head Widening Implants Case Example and Design Guidlelines

Female head widening implants are designed to increase the bitemporal width (side-to-side dimension) of the skull in women whose heads appear disproportionately narrow. The goal is not to create a masculine appearance, but rather to produce a smoother, more balanced, and naturally oval cranial shape. The most common indications include: Congenitally narrow head shape with Read More…

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