Sorry, I have been been really busy with life and didn't even see that I had gotten replies on this or I would have clarified. I assume there's some way to get notified about replies, so I'll try to turn that on. I cannot think of everything to post all at once, which is why people can ask questions, but I did have another post in the doctor referral section that had a little more detail.
The implants were stock XL silicone implants (not custom ones), placed by Dr. Niamtu in Richmond. At the time I requested that he consider malar augmentation, and as of the time of the surgery, I thought this was the plan, but that's not what happened. He instead placed only submalar implants, and more laterally than is typical, so he told me. And yes, you're absolutely right that they accentuated my orbital rim deficiency and made my negative vector worse. Bingo. That's especially true because the doc did a lower lid bleph which also removed fat from the area, leading to what looks like a cavity. where the fat was removed and the skin just dropped. Niamtu is a good and pretty conservative doctor, but this one didn't go so well, and he admitted that to me.
To clarify, for Lazlo: Dr. Sinn absolutely told me that the osteotomy he proposed (not the box osteotomy) would not move my lower orbital rim forward. I asked him that question explicitly because my understanding (from this forum) is that it would move it forward and help my orbital rim deficiency. He said that if he made the cut far enough over to move the orbital rim, I would need a neurosurgeon present, which would cost over $70k. I assume that's because of the presence of the infraorbital nerve. If he cut far enough over on the bone, he would be past the infraorbital nerve. This of course complicates the surgery. Now with that said, I believe the cut he makes would have to move the lateral part of the orbital rim. I don't see how else he would move the zygomatic bone, but I didn't really go into a lot of detail with this because he recommended that we go with custom implants instead.
Will be happy to upload the picture of the skull model Dr. Sinn showed me with the area of the osteotomy highlighted. I am one of those sad people who takes a picture of everything, though! So I have to sort through something like 30,000 pictures to find it! (I know how to reduce it if needed.)
Thanks Lazlo for confirming the directions could be followed. If the file size was in excess of what could be uploaded here, than perhaps IMGUR would be the place for the OP to put them.
The OP certainly does seem confused and not well researched enough to have gotten much out of the consultation.
I'm assuming the photo the OP tried the upload was that of a skull model Sinn showed.
I'm also assuming the implants the OP probably had prior were CHEEK implants that just made the orbital rim area look MORE recessed by relative comparison.
Other than that, if someone can't post photos (or doesn't want to post photos of themselves), doesn't know what to ask during a consult, doesn't clarify in the string what kind of implants they had in the past, I would not expect much clarity as to articulating to you what Sinn showed them vs. what he showed you.
ETA: Just did a search on the OP's post and the 'implants' were said to be extra large cheek implants.
