Author Topic: Repeated zygomatic sandwich osteotomy to get high cheekbones?  (Read 22294 times)

Vic

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #45 on: February 25, 2017, 09:29:53 AM »

Yes I've seen 4 impressive ZSO results that definitely increased the subjects attractiveness quite a lot. I've seen hand carved ePTFE orbital rim implants and one medpor implant that also covered the very top part of the cheek that also boosted the subject's attractiveness by a crazy amount. I've yet to see  any examples of purely malar implants increasing a male's attractiveness but I'm sure there are some out there.

Can you upload the pics of the 4 ZSO's?

The Quest for Aesthetics

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #46 on: February 25, 2017, 09:36:44 AM »
Can you upload the pics of the 4 ZSO's?

Two are private results so I can't upload those. One is in an old Mommaerts paper, I'll find it later and the other one is the girl that's regularly posted on here. The one that made the most difference attractiveness wise was one of the Zarrinbal private results

Vic

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #47 on: February 25, 2017, 10:08:50 AM »
What was special about Zarrinbal's result?

ditterbo

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #48 on: February 25, 2017, 12:00:59 PM »

Yes I've seen 4 impressive ZSO results that definitely increased the subjects attractiveness quite a lot. I've seen hand carved ePTFE orbital rim implants and one medpor implant that also covered the very top part of the cheek that also boosted the subject's attractiveness by a crazy amount. I've yet to see  any examples of purely malar implants increasing a male's attractiveness but I'm sure there are some out there.

The issue is of course that 'improving' the zygos by projecting them is only one aspect of the overall facial structure. Most people have too many other aesthetic issues holding them back for movement of the zygomatic prominence to make much tangible difference. Whether that's bodyfat, poor maxillo-mandibular formation (including a narrow central column of the face), poor skin quality, narrow interpupillary distance, excessively long philtrum/midface, unsightly eyes, unsightly mouth area; so on and so forth

The other thing to bear in mind is that zygomatic projection needs to be in harmony with the rest of the face. You can't have protruding zygos and recessed everything else - it will look unnatural. Especially the zygomatic-maxillary relationship

Alright so I presume you've seen my forum threads before, as an example of someone with a hawk face (V shaped).  If ZSO's really only help on faces with average to wider, forward rotated maxilla's, then If/when I get bimax, I should be insisting on either SAPRE or a 3 piece lefort to widen my maxilla?  I haven't paid attention to the myofunctional device threads but that's another avenue to run down. I know my lower arch is a little narrow per my ortho, so my upper must be the same.   


EDIT- Milli Meters & company - y'all need to start taking 'clinical' photos if you want the best guestimate from people on this forum.  Straight-on headshot from ~5-feet away (don't quote me on distance), 45 degree angle profile shot, and side profile shots.  Consistent light source aimed squarely at your face with no side shadows.. These candid photos would barely even fly on realself Q&A with the doctors pushing PS surgery at the slightest silhouette they see before turning the page.
« Last Edit: February 25, 2017, 12:33:16 PM by ditterbo »

The Quest for Aesthetics

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #49 on: February 25, 2017, 12:53:48 PM »
Alright so I presume you've seen my forum threads before, as an example of someone with a hawk face (V shaped).  If ZSO's really only help on faces with average to wider, forward rotated maxilla's, then If/when I get bimax, I should be insisting on either SAPRE or a 3 piece lefort to widen my maxilla?  I haven't paid attention to the myofunctional device threads but that's another avenue to run down. I know my lower arch is a little narrow per my ortho, so my upper must be the same.

It's not to say that they won't help at all in these cases, but the strongest indication for a ZSO would obviously be where the zygomatic projection is the only thing severely deficient. It's pretty indisputable that beautiful faces are broad, namely in the 'central column' of the face (as a general rule, there are many exceptions). So broad IPD, laterally elongated orbital sockets, a broad maxilla from top to bottom and a broad lower palate. SARPE would only deal with the upper palate, and if done alone will probably make little difference. 1) because it's limited by the position of the lower palate, 2) because broadening one portion of the face to the exclusion of others is a recipe for disharmony and looking strange. Ideally you would need to broaden both palates significantly, broaden the central and upper midface (essentially pushing out laterally the point at which the maxilla transitions into the zygomatic bone - including the position of the inferolateral rim), and broaden the supraorbital rim and the eyebrows also. You would then need to modify the border of the mandible, the rest of the zygoma and possibly the temporal region to sit in harmony with the now expanded central column of the face. Ideally you would also broaden the eyes and the IPD but it is practically impossible. You will probably need to broaden the mouth with a lateral commissuroplasty also.

It is even more complicated because beautiful male faces tend to exhibit what I call a lack of exterior sagittal depth to most of their features, in addition to overall breadth. All this means is that the maxilla, the zygoma, the lower palate and the orbits (including the lateral and supraorbital areas) tend to be very 'tabletop' in appearance. All this means is that the the lateral aspects of these features (which if you recall are already broad, since breadth is an independent variable), are not too far behind their central aspects. This is where angularity of features ties in - obviously features like the zygoma have to retreat backwards sagitally where those features end (on the transverse plane). Given that these features a) lack 'exterior sagittal depth', and b) must retreat backwards at some point - those features usually become angular and 'chiseled'.

This is of course also in addition to 'forward projection', 'rotation', 'vertical set' and other issues related to the 'shape' of features; which are obviously important also.

What was special about Zarrinbal's result?

It wasn't the result that was special per se. It was the starting point of the patient. Essentially the individual had bimax advancement and the relationship between the maxilla and the zygoma looked really bad, in fact it looked creepy. The large difference in attractiveness was in correction of that awful disharmony.

Milli_Meters

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #50 on: February 25, 2017, 12:56:52 PM »
Hi Ditterbo. I agree an opinion based on candid pics may involve a serving of a grain of salt but I would rather get an opinion from some one who has seen results than have no opinions before I meet with the doc myself. I am not looking for a detailed analysis, just a yes no or maybe. Posting clear pics may not be acceptable to everyone's sense of anonymity.

I am just wondering if the disparity in people's opinion of this procedure is based on how the underlying bone looked before. I have spoken to a few folks who are genuinely quite satisfied with it.

Vic

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #51 on: February 25, 2017, 01:39:56 PM »
Hi. Those of you that have seen ZSO results , TQFA et al , if this pic represents the starting point - would Zso help get better definition? Thanks.

Photo quality is crap

PloskoPlus

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #52 on: February 25, 2017, 02:57:06 PM »
IOW, the ideal male face should be like a block of granite (within reason ) - "straight, not rounded bones". This is basically about your cranial development. Chris Carmacks are born, not made.

Vic

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #53 on: February 26, 2017, 01:23:05 PM »
Oliver Cheshire must have some of the best cheekbones around which don't seem very high. I don't think high cheekbones are everything but more prominent

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Vic

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #54 on: February 26, 2017, 01:23:53 PM »
pic

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The Quest for Aesthetics

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #55 on: February 26, 2017, 02:16:32 PM »
Oliver Cheshire must have some of the best cheekbones around which don't seem very high. I don't think high cheekbones are everything but more prominent

Again, I disagree.

Vic

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ditterbo

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Re: Repeated zygomatic sandwich osteotomy to get high cheekbones?
« Reply #57 on: April 17, 2017, 11:50:46 AM »
I found a way to get Gunson's 3D CT scan into a program that overlays everything into a skull, and it didn't take long to see there's an obvious boney deficiency of some sort, in the whole ZMC.  I just don't know yet if there's an individual piece of the ZMC that is deficient, or the whole thing is just small and needs advancement through like a modified lf3. This is the ZMC you don't want, folks. I can just google-image skulls and see a lot more prominent malar and submalars than this on the random ones up there.



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