CHEEKBONE/SUBORBITAL, ZYGOMATIC ADVANCEMENT!!

[Jack]

Hey guys,

thought I'd suggest a thread where we could gather information on this topic. So in conjunction with my jaw surgery I would also like to have a more prominent cheekbone/malar/suborbital area. I don't like the idea of medpor/sillicone implants and I'd like to achieve this with my own bone or hydroxyapatite paste in conjunction with fat injections.
Many people who have weak lower jaws or maxillas also have deficiencies in bone contour and projection to the suborbital/malar region. There seem to be several solutions. One could have something like a lefort-2 or lefort 3 osteotomy, but unless you have something like Crouzen's syndrome or whatever, you really, really don't want that -since its quite a dangerous surgery and the incision is made around the hair line and the whole face is moved forward.

I've only seen one example of a zygomatic/malar advancement and that is on this patient by Dr. Mommaerts. Scroll down to the woman with red hair --many of us have seen this pic. Assuming this actually IS a malar osteotomy I would say the results are absolutely amazing. I think the "moldable mandibular angles" are achieved through HA paste. I corresponded with Dr. M. who is in Belgium and he said that the zygomatic advancement is not a difficult procedure to perform at all and that there must be several surgeons who do this in North America. He only charges a few thousand dollars for the procedure and I think the aesthetic pay-off is HUGE. Assuming the risk of nerve damage etc. isn't big in that area, what do you guys know about cheekbone augmentation? Again, I'm not interested in implants save for HA paste --but as CK has indicated, he felt the HA paste didn't make any big aesthetic difference. I've heard otherwise, but I haven't had this corroborated with any visual evidence.

http://www.mauricemommaerts.eu/en/pathology.aspx

Does anyone know if Dr. Gunson or Arnett perform this malar advancement procedure? Sounds like if anyone did it would be them, but perhaps it's out of their interest or range of interest? I've also received confirmation that Dr. Schendel performs the zygomatic advancement surgery, but when I pressed him in email, he said implants were his preferred method. Dr. Mommaerts was quite ready and enthusiastic about it though. I'm a bit confused because Dr. Schendel is a HUGELY respected craniofacial surgeon.

Here's the link to the "modified lefort 1 with zygomatic advancement" as you can see it's quite old, but the results sound promising --I don't want to pay for the article...

http://www.ncbi.nlm.nih.gov/pubmed/1890522

Okay, let's use this thread to get information about how to best go about addressing these issues!



I've also read of a "modified lefort 1 with zygomatic advancement" but d



 

[Jack]

the hydroxyapatite grafts weren't that expensive compared to the rest of the surgery, i just didn't think they did that much for me beyond protecting my existing features. my cheeks weren't very hallow to begin with. i think "cheek" is an ambiguous word, i was under the impression the puddy-mold substance (he described it in a mold-like form so that's how i see it in my head) to enhance the cheek bones in general.

 i really think you need to lower your expectations bro.

i like HA more than implants, because implants are fake...but if the aesthetic result is better and more positive facial harmony than go for it. i dont know if this is a fact or not, but i believe AG can place the HA in critical sites like the malar and paranasal bone. not sure if they would just do cheek grafts and not jaw surgery, doesn't seem like it would be worth their time since they are so busy.

fat injections sounds weird.

CK, fat injections might sound weird to you but they are a standard procedure in facial augmentations of all sorts. I understand that you're particularly ignorant on these matters but there's no need to label something as "weird" just because you've never heard of it before.

As for my expectations, I'm only speaking from the visual evidence of the patient on Dr. Mommaerts website. I would be very happy with her results and those are certainly achievable. So if that's clearly possible then why should I NOT hope to achieve a similar results?

I think you've provided valuable information in the form of the HA paste not providing you with any visible aesthetic augmentation --but then you never specified or asked for anything specific to be achieved.

What I asked was whether AG did malar osteotomies like Dr. Mommaerts which we don't know, though I'm guessing not since only a few handful of surgeons seem to do this procedure. Maybe it's particularly risky? I don't know enough about it.

[Antbee]

fat injections don't last forever in most patients. In fact a lot of patients find the fat is reabsorbed pretty fast (can't be bothered to find the original stats I read right now but the odds weren't good)

[Jack]

fat injections don't last forever in most patients. In fact a lot of patients find the fat is reabsorbed pretty fast (can't be bothered to find the original stats I read right now but the odds weren't good)

this is all true. there is a dr. lam in texas who discusses a procedure where fat can be grafted in such a way where it becomes more permanent, but that carries other problems --i.e. you don't want fat cells growing too much on you face or you'll look bloated. regardless, it is very common now and has other benefits such as improving skin texture etc.. --adipose fat cells are a type of stem cell and improve healing, skin texture etc.. it's really just an alternative to doing restalyne injections or other such fillers which people also use to augment deficient parts of their facial structure. this is one of the problems with implants, they don't address everything, you need soft tissue augmentation also after a certain age(usually your forties).

i think the thing that's confusing me is that if the type of results achieved by the red haired woman in the Dr. Mommaerts pic are possible, why aren't more people doing this procedure or more doctors offering it. I'm thinking maybe there are a lot of risks or perhaps that pic is not really a "malar osteotomy". don't you guys agree that the changes to her jaw width and upper cheekbone area are really impressive?

[neferkitti]

this is all true. there is a dr. lam in texas who discusses a procedure where fat can be grafted in such a way where it becomes more permanent, but that carries other problems --i.e. you don't want fat cells growing too much on you face or you'll look bloated. regardless, it is very common now and has other benefits such as improving skin texture etc.. --adipose fat cells are a type of stem cell and improve healing, skin texture etc.

I don't know about fat grafting. Control over permanence is iffy, but an additonal problem that I can foresee is that these grafted cells are living, changing size. That is hard to control, regardless of surgeons' skill. IMO, there is a greater potential for uneven skin texture as those cells wax and wane and absorb unpredictably.

[x]

Bumping this, what's the general consenus on malar osteotomy? http://www.ncbi.nlm.nih.gov/pubmed/15058548

I don't see why this isn't being talked about more, from most accounts it seems a cheap & relatively low risk procedure: http://www.clinicexpert.com/information-on-malar-osteotomy/

are the results not spectacular yet or something?

[Rico]

I'm gonna have malar bone osteotomy. I think the problem is that is not so easy

[Lazlo]

I'm gonna have malar bone osteotomy. I think the problem is that is not so easy

yeah good luck finding someone to do it. let us know how it went once you have the results.

[earl25]

im still not convinced a malar oesteotomy will help directly under the eye.

also it is very hard to find a dr. in usa or canada to do it,however i do beleive as more and more ppl do it and post about it it will lead to more dr.s being open to it

[earl25]

also a dr. telling u via email he will do it means nothing. i had several doc do that, onc you get in the office they say its not that bad ,why not try fat or filler. then they say how dangerous and scary the procedure is. then thy still make you pay for the const

[Rico]

Yes I was in such situation a few times.
Tomorrow I'm meeting one surgeon in Italy who claims that he can do malar bone osteotomy in relatively safe way. I will see...

[Rico]

Look at this: http://jawsurgeryforums.com/index.php/topic,4137.msg31045.html#msg31045

[Avra68]

Please let me know if you found a reliable surgeon, with a lot of expertise & practice in this surgery.