Repeated zygomatic sandwich osteotomy to get high cheekbones?

[Vic]

Yes sideways and forwards which provides the biggest impact visually. He said he can move them slightly upwards but not as much as he can from the side and forward, which is the direction you'd want the biggest change anyway

[Lestat]

He said that the 10mm movement is more than enough to show a big change

Does he also have before and after pictures?

[Lestat]

We are talking about gaining high cheekbones. It's common knowledge the ZSO provides decent lateral and anterior projection.

Better than nothing!

[Lestat]

To compensate for the small upwards movement he puts a bone graft on top.

Does the bone graft not resorb, if you use it as an onlay? I am pretty sure it will!

[PloskoPlus]

I had the ZSO. It gave minimal change, and the change it did give was on the lower cheekbone. I did have a great pre-op consult in which we decided I liked high cheekbones with good visibility. The result was very different. Would really not recommend this procedure.

This has been the experience of at least another 2 patients of  Dr Z. One even went through the trouble of  manufacturing a skull model to show him exactly what she wanted. Didn't help. IMO he clearly oversells the procedure.

[Lazlo]

Stupidjaws procedures look good from his ZSO but I think stupidjaws' cheekbones were already on the higher front and it looks good. Also wouldn't at least a good degree of anterior projection push out or "tent" the skin under the eye, at least making it more convex? I don't know, I just hope.

I think probably for best impact you'd want the mf3 and then get the ZSO for good measure. But yeah, we're clearly dealing with the problem of how the f**k do you move the cheekbone up before moving it out. f**k>

They can do face transplants but can't figure this s**t out.

I'll tell you something for truth. Docs who can't do things say it can be done. Docs who know how to do things will oftfer them --but what I don't like is the morons who don't know saying that's its not possible or not a good idea.
They should just say, "I DON"T KNOW OR I DON"T KNOW OF ANY"

I mean almost ANYTHING IS POSSIBLE.  I mean if you watch this video you'll see they attached an entirely fully functioning jaw with teeth to this guys face and they had medical engineers working to guide the cuts and how to construct the jaw and attach all the nerves and make it as cosmetically viable as possible --so f**k off when people say s**t can't be done.

http://www.dailymail.co.uk/health/article-4233744/Face-transplant-recipient-hails-staggering-results.html

It's just, can you afford a team of 50 surgeons to work on your case? That would be millions. But I bet most of the things we think aren't possible are still possible given today's technologies even.

We can even make short people tall.

[PloskoPlus]

GB,

These are the ones I was referring to.

[ExtractionsRuinFaces]

So I just had a call from Dr Z a minute ago, I spoke to him about the ZSO, he said he has his own method of the cut which no one else does, which provides more projection. I tried to get him to send me a diagram of it but he said he doesn't want to give out any details about it yet as he's in the process of getting it published, so he doesn't want any other surgeon stealing his method. He did say that he can get 10mm of projection and advised that 10mm is a lot anyway. He said using his method he can get the projection high up to show the shadow under the cheekbone.

When I saw Z he did indeed mention something about a technique to raise the cheekbone high up. I can't remember much about the consult unfortunately as I didnt take any notes and the consult was a while ago.

[Lestat]

baldguy - can't find relevant quotes as it was probably from missj, but he said similar things. Perhaps he can post if he sees this.

Baldguy83 - via PM (I think it is ok to post it here):

The result was OK, it gave my face more lateral width, which I really needed. I had a narrow face before. The added width was placed lower on the face than I would have liked, though, but that's really limited by the current placement of your cheekbones. Don't expect to get model-tier cheekbones if you don't already have high (but poorly pronounced) cheekbones.

He used bone from the iliac crest yes. You will end up with a 3-4 cm long scar there. Not a really big deal for me.

It did not give any anterior projection, nor did it give the rest of my midface more projection. It made my under-eye hollows more prominent, rather. I have gotten a modified mid-face lift (apparently I did have some fat but it was placed too low) and bone grafts to address that, I am recovering from that now.

I asked him again if a zso makes the under-eye-hollows more prominent. That was his reply to me:

Yes, your under eye hollows become more prominent.

I asked a surgeon who does zso about that. He told me that it is completely nonsense. I believe him.

[Lestat]

About malar augmentation:

"Chubby faces show a preponderance of the posterior over the anterior plane. Lateral soft tissues such as in the temporal and buccal area show increased convexity and dominate the facial appearance. The buccal region should be slightly concave or flat in adults, within the confines of a tangent from the cheekbone to the mandibular angle. Fullness in the buccal region can give the illusion of a poorly developed malar eminence. In these patients, partial excision of the buccal fat pad may be indicated.
Shadowing in the concavity of the buccal area highlights the malar eminence, giving it a sculptured, well-defined look. Caucasian women tend to accentuate this effect by using makeup, whereas Asians prefer much softer contours. But excessive buccal hollowness results in an emaciated, gaunt appearance with exaggerated malar definition.

Excessive width and prominence of the mandibular angle and masseter muscles make the malar eminence look small and give the face a square or triangular shape. Reduction of the mandibular angle and masseter muscles might be more adequate than malar augmentation."

https://www.researchgate.net/publication/8639801_Aesthetic_malar_recontouring_The_zygomatic_sandwich_osteotomy

[Vic]

I'm still trying to figure out where the line is between having high & low cheekbones?

[ditterbo]

Ya I'm looking at my skull scan and can't tell how high or low they are. what are the relative landmarks and proportions we're defining here for low vs high cheekbones?

[diculo]

Thanks, yeah I did hear about the swelling remaining for a long time. I think that I'll ultimately need fat replaced as well, as I have none in my mid-face area, but I've been told my bones are deficient too. I'm not worried about the lowset cheeks complaint with this surgery, as I feel like that is the part that I need addressed. I know it is regarded as typically feminine but for my face it seems to be the area that needs to be improved the most. Closest example I can find of what I have is this guy


My eye isn't quite as bulging but the shape and flatness is the same. I like the look of the area that he has had projected too, despite it being an implant.

Is there anyway to fix bulging eyes?

[ExtractionsRuinFaces]

Is there anyway to fix bulging eyes?

Orbital decompression

[diculo]

Thanks, yeah I did hear about the swelling remaining for a long time. I think that I'll ultimately need fat replaced as well, as I have none in my mid-face area, but I've been told my bones are deficient too. I'm not worried about the lowset cheeks complaint with this surgery, as I feel like that is the part that I need addressed. I know it is regarded as typically feminine but for my face it seems to be the area that needs to be improved the most. Closest example I can find of what I have is this guy


My eye isn't quite as bulging but the shape and flatness is the same. I like the look of the area that he has had projected too, despite it being an implant.

What surgery did he get?