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Custom Facial Implants – Mechanisms of Intraoperative Misplacememnt

There are two factors that determine the success of custom facial implants, the implant design and its intraoperative placement. The implant design is assured but placing exactly how it is designed is not. Such implants can end up a few millimeters off from ideal placement. A few millimeters doesn’t sound like much, but on the Read More…

Custom Facial Implants – Techniques in Intraoperative Placement

Since custom facial implants simply don’t snap into place, as some surgeons falsely allege, how is implant position assessed intraoperatively beyond just “eyeballing”. Having done several thousand custom facial implant placements, revisions and adjustments here are several techniques I use to verify implant position beyond just looking at it. These are important as in most Read More…

What is Aesthetic Skull Reshaping Surgery

Every day I get inquiries from patients requesting ‘skull reshaping surgery’ without any further specifications or details of their head shape concerns, not recognizing the scope of the general term. A detailed description of what encompasses skull reshaping surgery is described. What is Aesthetic Skull Reshaping Surgery Aesthetic skull reshaping surgery—often called cranial contouring Read More…

Custom Jawline Implant Removal Outcomes

Custom jawline implants create one the most powerful augmentation changes of the face. Their wraparound surface area coverage of the entire inferolateral border of the lower jaw can cerate a dramatic contour change between the face and the neck. But despite these potential benefits not every jawline implant patient is satisfied with and may consider Read More…

Jawline Implant Removal: Frequently Asked Questions

Considering jawline implant removal here is what you need to know. Will my face go back to normal after jawline implant removal? Not completely. While your face will return closer to its natural shape, the tissues and bone have adapted to the implant. Most patients notice a slight loss of jawline definition and a softer Read More…

Direct Browlift in Vertical Orbital Dystopia Case Example

A direct browlift is a brow-lifting operation in which skin is removed just above the eyebrow, and the brow is elevated by closing that excision. It is mainly used to treat brow ptosis, especially when the droop affects the upper visual field or creates significant asymmetry. Compared with endoscopic or coronal brow lifts, the direct Read More…

Custom Facial Implants and Patient Age – Guidelines for Surgery

Patient age matters with custom facial implants, but not because there is one magic cutoff. The real issue is whether facial skeletal growth is essentially complete and whether the patient has the maturity and expectations for a permanent implant procedure. Teens in particualar should meet milestones in growth and physical maturity before plastic surgery, and Read More…

Decision Tree for Implant vs Genioplasty in Revisions

In treating chin implant asymmetries the decision is between implant revision vs. sliding genioplasty. This is how to think about that choice in a structured manner.s Decision Tree: Implant vs. Sliding Genioplasty (Revision Cases) Step 1: Is the implant malpositioned? YES Proceed with implant revision (reposition ± pocket correction ± fixation) NO go to Step Read More…

Ear Lift For Asymmetry Correction Case Example

If an ear “sits too low,” you’re usually talking about vertical malposition of the ear, not projection (how far it sticks out). That’s a more specialized issue than a standard otoplasty. Here’s the reality: there isn’t a simple “ear lift” like there is for the face. Fixing a low-set ear typically means surgically repositioning the Read More…

Female Forehead Osteoma Removal Case Example

Forehead osteomas are benign (non-cancerous) bone tumors that commonly appear on the frontal bone of the skull—basically the forehead area. What they are Made of dense, mature bone Typically slow-growing Feel like a hard, immovable lump under the skin Usually painless Why they occur The exact cause isn’t always clear, but possible factors include: Genetics Read More…