High cheekbones

[AustralianLabrador]

"Comes with the vertical growth pattern. Sorry but low cheekbones can't be fixed Best you could do would be to augment on top of them in a higher location, assuming you have midface hypoplasia to begin with. In that case you'd augment above, which might be ok if you're a girl and if not it'll give you a feminine look. This is not a great problem to have."

This was a quote by molestrip and to be honest it doesn't sound right.

Unless you have cheekbones that start below your mouth (hyperbole) then there is no reason a combination of:

-single or multiple ZSO
- Custom Implants with arch
- Orbital rim augmentation
- MLFIII

won't

give you high cheekbones

[Milli_Meters]

The one mlf3 thats been seen gave low feminine cheekbones. Even when cut as high as possible.

I am leaning towards zso + infraorbital implants.

[AustralianLabrador]

Yeah but ZSO + Custom implants for cheekbone/zyg arch + infraorbital REGARDLESS of whether you need MLIII will work incredibly well to almost everyones liking

[Wheatsnax]

modified oblique lefort 3





lefort 3 cut moves both forward and upwards in a diagonal movement. it was created to take into account vertical maxillary excess which includes downward grown cheekbones

if you do a simple horizontal advancement you're just advancing along along the downward growth plane, just like how a straight bimax will produce bad result when rotation is warranted. if the dude above got a simple ll3 (with or without lf1 level seperated), his result would have been worse

if you look at the syndromic patients who do this, their jaws are extremely steep and the cephs for planning aren't at an ideal horizontal plane either. of course aesthetics aren't the priority but the surgeons are adopting this same technique to non-syndromic patients.

[PloskoPlus]

Hard to say what effect it had on the eyes.  I wonder if there is a step off at the sides. Looks like the nose was involved as well. I guess the bridge is raised.

[AustralianLabrador]

modified oblique lefort 3





lefort 3 cut moves both forward and upwards in a diagonal movement. it was created to take into account vertical maxillary excess which includes downward grown cheekbones

if you do a simple horizontal advancement you're just advancing along along the downward growth plane, just like how a straight bimax will produce bad result when rotation is warranted. if the dude above got a simple ll3 (with or without lf1 level seperated), his result would have been worse

if you look at the syndromic patients who do this, their jaws are extremely steep and the cephs for planning aren't at an ideal horizontal plane either. of course aesthetics aren't the priority but the surgeons are adopting this same technique to non-syndromic patients.

so that diagonal up movement and/or

+ further zso + custom implants

is legit all thats needed

[AustralianLabrador]

Just want to note I actually do need a MLFIII

I've been offered it and I'm ecstatic but I won't commit until I learn more

[kavan]

The diagrams and photos are an example of a person who legitimately needed the Lefort 3 with the modification of it shown in the diagram. That's demonstrated in the before/after photos and cephs.

The upper part is basically a 'classic' Lf3. The only modification of it is the separate cut used to perform the Lefort 1.

[boyo]

I've seen that advice to get ZSO + implants now several times as the ultimate solution to get high cheekbones, and it is bullocks. Those surgeons I've spoken to said the ZSO will create such a step-off that makes it difficult to maneuver an implant on the orbital rim. Is it possible? Possibly, but you'd need a customized orbial rim implant since it would have to fit above the step off from the ZSO. If you have a verticallly short zygoma that's going to be a lot more challenging to accomplish. And you can forget about getting a not customized orbital rim implant (unless the surgeon can carve it perfectly well to fit that area above the ZSO cut while you're on the operating table, but that is by far not failure proof).

Second point: most of the projection is on the lower part of the cheek with a ZSO, and part of the lataral portion of the cheek will be moved too. Ideally most persons with a recessed midface would get good projection also on the higher, more lateral part of the zygoma (malar prominence). That's just not going to happen with the ZSO. It will move the segment (and that entails mostly the area underneath the malar prominence) 'en block' outwards. Some surgeons say they can rotate the segment a bit, don't expect too much of that until we see that in an actual result. So you can not just choose where you want to get most projection, and it will not be on the malar prominence with the ZSO. Doesn't matter if you put an orbital rim implant above it. Again: the cut of the ZSO is through the lower part of the zygoma, and it can mostly be moved outwards/laterally with if you're lucky a little bit of extra anterior projection. You can not determine where you want the most projection: it is just your own bone that moves outwards. And with the ZSO most projection is not going to be on the malar prominence.
Only if your orbital rim implant would also cover part of the malar prominence you could still get the amount of projection there that you would wish for. But with the step off of the ZSO that is going to be a problem.

And if you're going to get orbital rim implants anyway: why the hell would you still go through the s**t of a ZSO, and not get an implant that covers the malar prominence too? Sounds unlogical as s**t to first get a ZSO and then still implants.

Amen. Just jump over the whole ZSO part and get the custom made extended orbital rim implant and you should get the most optimal result.

[Bowie]

I've seen that advice to get ZSO + implants now several times as the ultimate solution to get high cheekbones, and it is bullocks. Those surgeons I've spoken to said the ZSO will create such a step-off that makes it difficult to maneuver an implant on the orbital rim. Is it possible? Possibly, but you'd need a customized orbial rim implant since it would have to fit above the step off from the ZSO. If you have a verticallly short zygoma that's going to be a lot more challenging to accomplish. And you can forget about getting a not customized orbital rim implant (unless the surgeon can carve it perfectly well to fit that area above the ZSO cut while you're on the operating table, but that is by far not failure proof).

Second point: most of the projection is on the lower part of the cheek with a ZSO, and part of the lataral portion of the cheek will be moved too. Ideally most persons with a recessed midface would get good projection also on the higher, more lateral part of the zygoma (malar prominence). That's just not going to happen with the ZSO. It will move the segment (and that entails mostly the area underneath the malar prominence) 'en block' outwards. Some surgeons say they can rotate the segment a bit, don't expect too much of that until we see that in an actual result. So you can not just choose where you want to get most projection, and it will not be on the malar prominence with the ZSO. Doesn't matter if you put an orbital rim implant above it. Again: the cut of the ZSO is through the lower part of the zygoma, and it can mostly be moved outwards/laterally with if you're lucky a little bit of extra anterior projection. You can not determine where you want the most projection: it is just your own bone that moves outwards. And with the ZSO most projection is not going to be on the malar prominence.
Only if your orbital rim implant would also cover part of the malar prominence you could still get the amount of projection there that you would wish for. But with the step off of the ZSO that is going to be a problem.

And if you're going to get orbital rim implants anyway: why the hell would you still go through the s**t of a ZSO, and not get an implant that covers the malar prominence too? Sounds unlogical as s**t to first get a ZSO and then still implants.

Absolutely, guys want high cheekbones especially prominent on the arch right? Why have a procedure that enhances the very bottom part of the cheekbones?

[Milli_Meters]

I've seen that advice to get ZSO + implants now several times as the ultimate solution to get high cheekbones, and it is bullocks. Those surgeons I've spoken to said the ZSO will create such a step-off that makes it difficult to maneuver an implant on the orbital rim. Is it possible? Possibly, but you'd need a customized orbial rim implant since it would have to fit above the step off from the ZSO. If you have a verticallly short zygoma that's going to be a lot more challenging to accomplish. And you can forget about getting a not customized orbital rim implant (unless the surgeon can carve it perfectly well to fit that area above the ZSO cut while you're on the operating table, but that is by far not failure proof).

Second point: most of the projection is on the lower part of the cheek with a ZSO, and part of the lataral portion of the cheek will be moved too. Ideally most persons with a recessed midface would get good projection also on the higher, more lateral part of the zygoma (malar prominence). That's just not going to happen with the ZSO. It will move the segment (and that entails mostly the area underneath the malar prominence) 'en block' outwards. Some surgeons say they can rotate the segment a bit, don't expect too much of that until we see that in an actual result. So you can not just choose where you want to get most projection, and it will not be on the malar prominence with the ZSO. Doesn't matter if you put an orbital rim implant above it. Again: the cut of the ZSO is through the lower part of the zygoma, and it can mostly be moved outwards/laterally with if you're lucky a little bit of extra anterior projection. You can not determine where you want the most projection: it is just your own bone that moves outwards. And with the ZSO most projection is not going to be on the malar prominence.
Only if your orbital rim implant would also cover part of the malar prominence you could still get the amount of projection there that you would wish for. But with the step off of the ZSO that is going to be a problem.

And if you're going to get orbital rim implants anyway: why the hell would you still go through the s**t of a ZSO, and not get an implant that covers the malar prominence too? Sounds unlogical as s**t to first get a ZSO and then still implants.

Thanks for that perspective.

I want to get a zso because I feel my zygo shape is fine I just want to subtly widen the area. Maybe I am misguided. The infraorbital implants are more to deal with some lack of volume/dark circles under eyes but if they can extend on to the zygos and give some anterior projection in theory that should help my case.

[Milli_Meters]

Absolutely, guys want high cheekbones especially prominent on the arch right? Why have a procedure that enhances the very bottom part of the cheekbones?

What if you got silicone implants placed in the same area instead of cartilage? You reckon you would have had a similar outcome (sans the resorption) ? I have seen many implant results that look "puffy".

[Milli_Meters]

Absolutely, guys want high cheekbones especially prominent on the arch right? Why have a procedure that enhances the very bottom part of the cheekbones?

Idk tbh. I have seen many great looking guys with the much dreaded "lowjection". Jeremy Meeks , Johnny Depp , Brad pitt. I think its about over all harmony .

[kavan]

I've seen that advice to get ZSO + implants now several times as the ultimate solution to get high cheekbones, and it is bullocks. Those surgeons I've spoken to said the ZSO will create such a step-off that makes it difficult to maneuver an implant on the orbital rim. Is it possible? Possibly, but you'd need a customized orbial rim implant since it would have to fit above the step off from the ZSO. If you have a verticallly short zygoma that's going to be a lot more challenging to accomplish. And you can forget about getting a not customized orbital rim implant (unless the surgeon can carve it perfectly well to fit that area above the ZSO cut while you're on the operating table, but that is by far not failure proof).

Second point: most of the projection is on the lower part of the cheek with a ZSO, and part of the lataral portion of the cheek will be moved too. Ideally most persons with a recessed midface would get good projection also on the higher, more lateral part of the zygoma (malar prominence). That's just not going to happen with the ZSO. It will move the segment (and that entails mostly the area underneath the malar prominence) 'en block' outwards. Some surgeons say they can rotate the segment a bit, don't expect too much of that until we see that in an actual result. So you can not just choose where you want to get most projection, and it will not be on the malar prominence with the ZSO. Doesn't matter if you put an orbital rim implant above it. Again: the cut of the ZSO is through the lower part of the zygoma, and it can mostly be moved outwards/laterally with if you're lucky a little bit of extra anterior projection. You can not determine where you want the most projection: it is just your own bone that moves outwards. And with the ZSO most projection is not going to be on the malar prominence.
Only if your orbital rim implant would also cover part of the malar prominence you could still get the amount of projection there that you would wish for. But with the step off of the ZSO that is going to be a problem.

And if you're going to get orbital rim implants anyway: why the hell would you still go through the s**t of a ZSO, and not get an implant that covers the malar prominence too? Sounds unlogical as s**t to first get a ZSO and then still implants.

Agree with what ILTM is saying.

Will also add that Milli-meters and Australian Lab have either been the recipients of stupid advice or came up with the idea on their own to first have ZSO and then get implants over that when the smart thing to do is to just get the custom implants.

Milli-meters and Australian Lab....which is it..recipients of stupid advice or did you think that up yourself?

[Bowie]

What if you got silicone implants placed in the same area instead of cartilage? You reckon you would have had a similar outcome (sans the resorption) ? I have seen many implant results that look "puffy".

No I don't think it would have looked the same, yeah exactly silicone look puffy, i guess because it isn't as solid as cartilage or medpor or PEEK. I'd never have silicone. I bloody wish cartilage wouldn't resorb, it could have been the perfect material because it doesn't cause resorption of the underlying bone, HA paste doesn't either.