Limited Knowledge - Would like some advice

[Bendlowreachhigh]

Hi,

I'm not sure why but I have a long, flat, middle/lower face which I am hoping to address if possible and I just wanted to get some thoughts on how I can proceed. Front/Side pictures can be found here:

https://imgur.com/a/EGv80yj

Many thanks in advance

[kavan]

Hi,

I'm not sure why but I have a long, flat, middle/lower face which I am hoping to address if possible and I just wanted to get some thoughts on how I can proceed. Front/Side pictures can be found here:

https://imgur.com/a/EGv80yj

Many thanks in advance

Flatness is actually in the UPPER midface. Orbital rim area.

Surgical options:

Orbital rim implants with midface lift to shift midface tissue over more midface support that would be given by implants that project the deficient area out.

Bone cutting surgeries aimed at advancing out this area which which happens to be the culprit of your complaint but is 'challenging' to advance out via bone cuts.

Non surgical:

Soft tissue augmentation (fat or filler) to the 'lid cheek junction' with aim of creating a convex CURVE to the upper midface area as to mitigate the concavity to the area which gives appearance of 'long and flat'.

Surgical options are more limited than non-surgical ones because there is no shortage of doctors who address via the non surgical route where as the surgical options are going to be limited to a smaller segment of the surgeon population because they are more challenging to do with reference to a broad base of the surgeon population whether or not it's orbital rim implants or bone cuts to advance out a similar area.

If it's bone cuts to the area you want, perhaps some of the members who have had that type of surgery to advance out the area where you are deficient will come forth and give some suggestions.

[Bendlowreachhigh]

Flatness is actually in the UPPER midface. Orbital rim area.

Surgical options:

Orbital rim implants with midface lift to shift midface tissue over more midface support that would be given by implants that project the deficient area out.

Bone cutting surgeries aimed at advancing out this area which which happens to be the culprit of your complaint but is 'challenging' to advance out via bone cuts.

Non surgical:

Soft tissue augmentation (fat or filler) to the 'lid cheek junction' with aim of creating a convex CURVE to the upper midface area as to mitigate the concavity to the area which gives appearance of 'long and flat'.

Surgical options are more limited than non-surgical ones because there is no shortage of doctors who address via the non surgical route where as the surgical options are going to be limited to a smaller segment of the surgeon population because they are more challenging to do with reference to a broad base of the surgeon population whether or not it's orbital rim implants or bone cuts to advance out a similar area.

If it's bone cuts to the area you want, perhaps some of the members who have had that type of surgery to advance out the area where you are deficient will come forth and give some suggestions.

Thanks for the reply, I am open to all options and would like to hear from other members who have have/had a similar issue to me.

[dvfan]

Kavan gives you good advice.

You seem like you could benefit from BSSO + Lefort 1 with CWW rotation and posterior downgraft with a (subtle) genioplasty in these pictures. But the pictures are vague and would need better pics + cephs.

Glabella has nice projection. Superior anterior and lateral brow have nice projection. Your inferior orbital rims seem slightly recessed in those pics as Kavan wrote. Seems mostly medial inferior orbital rim, but I can't see if your lateral inferior orbital rims ar recessed too because of the poor light in your pictures.
Your submental fold seems deepened in these pics and any surgeon that would do jaw surgery + genio on you should have eye for that. But can't see your submental fold well because the pictures are vague.
Would be interesting to see your nasal tip projection and nasolabial angle after jaw surgery if you were to aim for jaw surgery.

[dvfan]

Soft tissue lifting is usually where dudes (or dudettes) can start to look not natural. Would not risk it: certainly not as a young dude. it can feminize too.
More anterior projection in your face will visually 'hoist up' the tissues somewhat. You don't have soft tissue sagging, you just could benefit from more anterior projection imo. If you want to raise the tissues (and imo if you were to end up with more anterior projection, you really do not need to raise the tissues), veeeeery subtle fat grafting in the tear throughs in combination with more anterior projection would give that visual result, versus aggressive facelifting with too often results that don't look natural and too feminine.

[Bendlowreachhigh]

Many thanks for your response, I have a meeting with a surgeon at the end of the month so I will see what they say and report back here.

[korvitz]

You look tired & have dark areas under your eyes, have you gotten an sleep study?

[Bendlowreachhigh]

No sleep study. I am considering asking my doctor for one.

I always thought the dark circles were due to some underlying bone issue.