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Custom Facial Implants – XI. Wider Foreheads and Enhanced Head Widths

The temporal area is a unique facial implant site for augmentation because it is not a skeletally based implant site and technically is not on the face. It is really augmentation of the temporal muscle, whether it is the non-hair bearing traditional temporal hollows (anterior temporal zone) or the hair-covered posterior temporal zone above and Read More…

Custom Facial Implants – X. Forehead Reshaping

Forehead augmentation is sought after by both men and women almost equally. Men typically seek the procedure to either correct a retroclined forehead slope or develop an overall stronger with more prominent brow bones. Women usually seek to have a rounder and more convex forehead with increased verticality. (i.e., the forehead is too flat or Read More…

Plastic Surgery Case Study – Subtotal #11 and #12 Rib Removal for Rib Tip Syndrome

Background: While the ribs are designed to provide protection and support of the lungs and other internal organs, there are instances where their very structure can be a source of pain. This is most relevant in ribs #11 and #12 which are both unattached on their anterior ends and point very obliquely downward. One source Read More…

Custom Facial Implants – IX. Brow Ridge Enhancement

A more prominent brow bone is an almost exclusive male aesthetic feature. While all men have some semblance of a brow bone, some are less defined due to lack of frontal sinus development than others. There are no preformed brow bone implants commercially available and making them by hand out of various materials works so Read More…

Custom Facial Implants – VIII. Raising the Bridge of the Nose

Of all custom facial implants made, the need for custom nasal implant designs is rare. They are so uncommon that in the near 1,000 custom facial implants I have ever designed and implanted, I have only performed a custom nasal implant twice. Due to the wide array of preformed nasal implants in both dorsal and Read More…

Custom Facial Implants – VII. Pulling the Midface Forward

Bringing the midface forward is often a desire from patients with an overall flatter midface profile. Such lack of midface projection may be present naturally (e.g., some Asian faces although it can occur in any ethnicity), may be present after trauma or may be persistent after a prior Lefort I ostetotomy. (incomplete midface correction) It Read More…

Custom Facial Implants – VI. Improving Projection of the Nasal Base

Many flatter midfaces in profile have an inadequate central midface projection. This is often called a ‘Lefort I’ deficiency referencing the procedure used historically to correct it when a Class III malocclusion is present. This is most manifest as a nose that looks sunken in at its base at the nostril level above the upper Read More…

Custom Facial Implants – V. Undereye Hollows and Negative Orbital Vectors

The treatment of undereye hollows has become commonplace with the widespread use of synthetic fillers and fat injections. While providing a solution for these aesthetic undereye concerns, such injection therapies are not perfect. Besides the lack of permanence for either fillers or fat, irregularities and contour issues from the added volume creates a need for Read More…

Technical Strategies – Injectable Fat Grafting for the Deepened Labiomental Fold After Sliding Genioplasty

The labiomental fold is a well known sulcus or depression below the lower lip at the upper end of the soft tissue chin pad. It is a fixed anatomic structure that represents the attachment of the mentalis muscle at the bone level and the depth of the lower lip vestibule intraorally. Because it is a Read More…

Custom Facial Implants – IV. The High Cheekbone Look

Standard cheek implants are designed to augment the main body of the cheekbone (zygomatic major) and have an oval shape to do so. This creates an anterolateral fullness which is primarily seen as more of an ‘apple cheek’ effect in malar styles) and an expanded version of that by filling in the soft tissue area Read More…