Widening cheekbones

[Questioning_Options]

We talk a lot about procedures that widen the mandible in these forums, but little about procedures that would widen the cheekbones, which seems important for keeping reasonable proportions during jaw surgery. From what I understand, the procedures are:

Natural tissues:
Orbital box osteotomy
Le Fort 3
Malar osteotomy (don't know much about this)
SARPE (controversial, but some people online seem to think that it has widened their cheekbones)

Unnatural:
Implants
HA Paste

Is there anything I'm missing?

[PloskoPlus]

Zygomatic osteotomies can give more later projection, a tiny bit anterior, but it will not make the cheekbones higher.  This is from a surgeon who does a lot of them.  And no, I have not seen any of his before and afters.

[terry947]

I wonder if there's a procedure that can rotate zygos or orbital rims CCW. So that they appear higher on the face or closer to the eyes. To give it more support. Also I noticed on good looking people that their zygos are more horizontal past the end of their eye brows if that makes sense. I'll post a pic later to show what I'm trying to say.

[meepmeepmeep]

I wonder if there's a procedure that can rotate zygos or orbital rims CCW. So that they appear higher on the face or closer to the eyes. To give it more support. Also I noticed on good looking people that their zygos are more horizontal past the end of their eye brows if that makes sense. I'll post a pic later to show what I'm trying to say.

ditto

[Lazlo]

I wonder if there's a procedure that can rotate zygos or orbital rims CCW. So that they appear higher on the face or closer to the eyes. To give it more support. Also I noticed on good looking people that their zygos are more horizontal past the end of their eye brows if that makes sense. I'll post a pic later to show what I'm trying to say.

First part yeah ditto, second i have no idea what you're talking about.  And I'm sick of you saying s**t like you'll post a pic later. Post it now motherf**ker and stop leaving us in ssuspense you goosefaced f**k. I'll annihilate you!

[Lazlo]

Okay heres an example of someone who is preternaturally good looking but let's use his as an ideal male face to discuss this. Obviously youth, steely blue yes etc. contribute to a lot hre but I'm interested in the relationship of cheekbones to jaw/chin. The face her is quite square. So what is it that creates that very almost gonial angle? I mean is it just density of bonee in that area? the chin is strong. Cheekbones wide, eyes very wide-set. It's Daniel Day-Lewis son, a guy who has one of the most sculptural, masculine and regal faces in the world.



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[PloskoPlus]

Okay heres an example of someone who is preternaturally good looking but let's use his as an ideal male face to discuss this. Obviously youth, steely blue yes etc. contribute to a lot hre but I'm interested in the relationship of cheekbones to jaw/chin. The face her is quite square. So what is it that creates that very almost gonial angle? I mean is it just density of bonee in that area? the chin is strong. Cheekbones wide, eyes very wide-set. It's Daniel Day-Lewis son, a guy who has one of the most sculptural, masculine and regal faces in the world.

"All happy families resemble one another, each unhappy family is unhappy in its own way." Leo Tolstoy.

Replace "happy family" with "attractive face", and the the above is still true.  Virtually all models have long ramus, high cheekbones, forward grown jaws.  Both male and female.  Once you notice this, it's hard to un-notice. 

[terry947]

[Lazlo]

I see what you're saying terry but except for the blue square i have all those qualities more or less that you've outlined with the black lines. So unfortunately I'm not sure it's quite proving anything.

[Lazlo]

Your features look like Chris Prat's and you want surgery?  Why?

No my jawline and chin are retrusive and not as chiselled at all and I have a larger more fleshy honker, I'm just saying my cheekbone WIDTH is similar and while I think I'm "okay" looking overall I don't have that degree of handsomeness (maybe after surgery!!).

[terry947]

I didnt have time yesterday to explain what the pictures mean. I've noticed this in of my good looking friends and people in real life. Though I doubt surgery can fix this? not sure...

I dont really know whats going on but from the looks of it seems that the zygos are past persons eye brows. Its the lateral/horizontal projection. If they were to lay their heads sideways on a desk their zygos would hit it before their eye brows ( if that makes sense). This is what gives them the s-curve. Lateral/horizontal projection. Obviously it has to also have some forwards projection.



also by ccw rotation I mean like CCW of the zygos and possibly lateral orbital rim to give more support to the corner of the eyes and possibly make the cheekbones look higher. impact  alittle bone where the top of the blue circle to make it rotate? I have no idea if any of this is possible, just an idea ive been having....

check out this thread page: http://jawsurgeryforums.com/index.php/topic,857.msg17122.html#msg17122

and this one: http://jawsurgeryforums.com/index.php/topic,1010.msg18598.html#msg18598

also look at this guys who had implants placed near the bottom corner of his eye. He looks way better: http://www.makemeheal.com/pictures/cheek-implants-lift/orbital-rim-implants-a11436

[Lazlo]

yeah but basically all i need is my orbital rims moved up (i.e. closer to my eye, this will reduce scleral show?) and also moved forward. That'll give a bit more lateral projection. I already have good lateral projection, the zygos are just set too low.

This is definitely doable. ANDD I WILL f**kING DO IT!!!!

I really need to fix my skin though, I have some bad scarring, like boxcar, ice-pick s**t. Will probably need fillers.

Guys, I'm pretty scared about this first phase of surgery. Well I am and i'm not, part of me is like it's gotta be better than the f**ked up bite my ortho has given me by extracting teeth.

But what will it feel like having tons of metal in my face. I mean for the genio, the mandible, the ramus drop in my case, and then all over again for my orbital rim, and maxilla. Jesus, Plosko, do you now set off alarms at airports??

Does that happen cause of all the metal in people's faces.

I gotta tell you something else. I have only ever met three people who told me they had jaw surgery, some class 2, some class 3 and I have to tell you, they ALL looked noticeably weird and f**ked up.

[PloskoPlus]

Jesus, Plosko, do you now set off alarms at airports??

LF1 plates will have to come out for any infraorbital osteotomies.  All maxillofacial plates are removable, alhough infraorbital plates may be harder to remove.  I'll take plates over implants any day.  Either move bones, or do nothing.

I gotta tell you something else. I have only ever met three people who told me they had jaw surgery, some class 2, some class 3 and I have to tell you, they ALL looked noticeably weird and f**ked up.

Yeah, my upper mid face looks like it's left behind.  The reality is, quite often a bad bite is associated with other "distortions" that also need to be fixed.  The best jaw surgery cases are where everything is good and only the bite is off.  I wonder how often that's the case.

[notrain]

The best jaw surgery cases are where everything is good and only the bite is off.  I wonder how often that's the case.

You can answer this question yourself: How many truly attractive people do you see in day to day life? Probably not many. Those few people have a class 1 bite and everything else fitting nicely in their faces. Now extrapolate that relationship onto all jaw surgery patients and you can see why there are so few good before and afters: People in general are pretty unattractive. If they have their skeletal malocclusion fixed they will still be unattractive afterwards.

Truth be told, there are a lot of real world before and afters over at progenica (german jaw surgery board) and among all of them there was 1 really good result (class 3 guy). Most results were meh, not because of a bad surgical outcome but rather the surgeon didn't have a good face to work with in the beginning. Some results are decent because they were young women caked in makeup. If I had to give numbers, I would say well below 5% of results were aesthetically worthwhile (i.e. patient will be perceived more favorably afterwards).

I gotta tell you something else. I have only ever met three people who told me they had jaw surgery, some class 2, some class 3 and I have to tell you, they ALL looked noticeably weird and f**ked up.

What exactly made them look f**ked up? How old were they? I don't think a sampling size of three people really means anything, but jaw surgery is performed so rarely that it is hard to meet anyone having had it done in day to day life.

My surgeon told me, if they (all maxillofacial surgeons in germany) were to operate on every skeletal malocclusion in the german population that could be justified by current medical parameters it would take 50-60 years until they were done with all cases. But that number only holds if no new cases were to occur in the population. I think this illustrates quite well how seldom this operation is carried out on people who might need / benefit from it.

[PloskoPlus]

You can answer this question yourself: How many truly attractive people do you see in day to day life? Probably not many. Those few people have a class 1 bite and everything else fitting nicely in their faces. Now extrapolate that relationship onto all jaw surgery patients and you can see why there are so few good before and afters: People in general are pretty unattractive. If they have their skeletal malocclusion fixed they will still be unattractive afterwards.

Truth be told, there are a lot of real world before and afters over at progenica (german jaw surgery board) and among all of them there was 1 really good result (class 3 guy). Most results were meh, not because of a bad surgical outcome but rather the surgeon didn't have a good face to work with in the beginning. Some results are decent because they were young women caked in makeup. If I had to give numbers, I would say well below 5% of results were aesthetically worthwhile (i.e. patient will be perceived more favorably afterwards).

It's my take on it as well.  Max fac just takes away the deformity.  So attractive with deformity becomes just attractive afterwards.  Ugly with deformity -> just ugly.  Although some manage to make a jump one rung up the ladder.

But for some people completely cosmetic operations like a chin wing can bring more aesthetic improvement than conventional "deformity-removing" jaw surgery.

What exactly made them look f**ked up? How old were they? I don't think a sampling size of three people really means anything, but jaw surgery is performed so rarely that it is hard to meet anyone having had it done in day to day life.

IRL, I'm the only one I know.

My surgeon told me, if they (all maxillofacial surgeons in germany) were to operate on every skeletal malocclusion in the german population that could be justified by current medical parameters it would take 50-60 years until they were done with all cases. But that number only holds if no new cases were to occur in the population. I think this illustrates quite well how seldom this operation is carried out on people who might need / benefit from it.

What percentage of the population would that be and what would be the most common deformity?  I heard 30% have a deformity of some sort, half of which are worth operating on, so that would be 15%.  I'd say various forms of class II go untreated the most.  That's the least objectionable deformity and can be camouflaged with jaw jutting, but that's just a guess.