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One of the most common male masculinization composite procedures is custom jawline and infraorbital-malar (IOM) implants. By creating a more visible/defined cheeks and jaw structure the face takes on a stronger and more defined appearance.Think of this as a ‘five corner’ approach to facial reshaping. (cheeks, jaw angles and chin)  In some cases those augmentations  alone creates the often desired inward contour between the cheeks and jawline while in other cases additional defatting procedures are needed to help create that effect.

While these male facial reshaping procedures can be very effective, it is important to be fully aware that this is a process in terms of both recovery as well as the distinct possibility that revision surgery may be needed. A brave patient of mine recently chronicled his history of the process online and it really illustrates what is a not atypical process from the start to achieving the final result.

As can be seen in the end, a great final result was achieved. But what lies between the beginning and this end is important to know. The first and most obvious part of the process is the swelling that ensues from the placement of facial implants that cover a large surface area as weak as involves five small incisions to do so. (lower eyelids, submental skin and intraoral incisions) While there is swelling the first day after surgery the peak swelling takes 48 to 7 hours to maximally appear. Then and only then does the swelling start to go down. One usually begins to look acceptable (not obviously surgical) in 10 to 14 days after the procedure.

Thereafter it is in the four to is week range when one is looking pretty good with 90% of the final result. This is also the key time that when reached the risk of infection has passed. More refinement of the result will occur over he following three to four months. Very much like a rhinoplasty the finest details of the result take a long time.

Once one reaches the three month mark after surgery a definitive assessment of the size, shape and symmetry of the implants will become evident. In this patient’s case some asymmetry of the left chin and jawline become evident and a 3D CT scan confirmed the need for secondary repositioning of that side of the jawline implant. Since he was having additional surgery anyway he decided to have some facial fat removed (buccal lipectomies and perioral liposuction) to further the facial reshaping effect of the implants.

In the end eight months after the process started, that included an additional surgery, a good final result was achieved. The take home message is that such significant facial reshaping is a process which takes times and may well involve a revision or second stage procedure to finally get there 

Dr. Barry Eppley

Indianapolis, Indiana

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