Cheek concavity

[PloskoPlus]

Plosko.....who is your surgeon?

PMed it to you.  Chose him because he seems more interested in aesthetics in general.  (The first surgeon I saw hardly even mention mid-face deficiency, just talked about the bite).  He wants to fix my nose as well, but only straighten it, because "It's mainly the crook and the receded maxilla that make it look big.  When your nose is straight and the maxilla advanced, it will be good enough.  Besides a small nose will not suit your big face".  Wants to do it at the same time as the jaw surgery.  I told him that usually people wait a year for the swelling to come down, etc..  He told me that I'm not a model with a tiny nose tip. 

My chin is long, but pointy (and I have a wide jaw).  I asked about genioplasty (widening it).  He said it's actually indentation/tapering in my jaw that can be filled in with HA paste (no need for osteotomy).

When I pushed him about aesthetics in general ie. is it worth going through all the trouble of jaw surgery just to come out looking different, rather than better.  He said that tastes differ, but at the very least I'll have a good bite.

I asked him about cutting nerves (have you ever?).  He said he cut plenty of nerves (!), and whoever claims to never have done so after doing thousands of operations is a liar.  Said he stretched far more than he cut.  And it's more of a problem in paediatric cases, when nerves grow in funny ways due to congenital disorders, but my nerves are pretty obvious, and I should be OK. Fun guy!

[PloskoPlus]

Talking about cheek concavity - I find Marco Mengoni's transformation interesting. Look at this
http://www.clandestinoweb.com/wp-content/uploads/mengoni-grasso-2.jpg

Now he has one of the best facial bone structures I've seen in a man. In the past, you could have said that he had the complete opposite of cheek concavity. His cheekbones - although they are perfect now, looked non-existent before. He has a beautiful S curve now, he had none in the past. Solution? apparently, he did not have any surgeries at all. All he did is loose fat. Even if you're not fat at all, do not underestimate the effect of excess soft tissue there, which you may have genetically.

Both jaws advanced.  The cheekbones look pretty damn good.  Almost a different person.

http://jawsurgerycamilla.files.wordpress.com/2013/09/before-after1.jpg

BTW,  I have flattish midface (underbite).  I came back from a holiday a couple of months back, losing 3-4 kilos in the process.  My parents told me that I looked like s**t and I should never again let myself become "so emaciated".  And, no, I was not anorexic, or anything.  So I'm looking forward to moving my maxilla forward, so I can then try to get down to 10% b.f. and not look haggard.

[Tiny]

Both jaws advanced.  The cheekbones look pretty damn good.  Almost a different person.

http://jawsurgerycamilla.files.wordpress.com/2013/09/before-after1.jpg

BTW,  I have flattish midface (underbite).  I came back from a holiday a couple of months back, losing 3-4 kilos in the process.  My parents told me that I looked like s**t and I should never again let myself become "so emaciated".  And, no, I was not anorexic, or anything.  So I'm looking forward to moving my maxilla forward, so I can then try to get down to 10% b.f. and not look haggard.

This girl looks great - I payed close attention to this as she has a similar profile to me.  Her cheekbones are strong before (common in class 2s) but the surgery (?rotation in the upper jaw) really made them pop.  There's a similar result in a woman with short face pre op

[Lazlo]

Talking about cheek concavity - I find Marco Mengoni's transformation interesting. Look at this
http://www.clandestinoweb.com/wp-content/uploads/mengoni-grasso-2.jpg

Now he has one of the best facial bone structures I've seen in a man. In the past, you could have said that he had the complete opposite of cheek concavity. His cheekbones - although they are perfect now, looked non-existent before. He has a beautiful S curve now, he had none in the past. Solution? apparently, he did not have any surgeries at all. All he did is loose fat. Even if you're not fat at all, do not underestimate the effect of excess soft tissue there, which you may have genetically.

so falco, basically you're saying that something to advance the maxilla and orbital rim, but leave the midface at a lower plane than those two would be ideal. in other words a higher cut lefort would bring the midface out but still leave the orbital rim depressive. yet celticcavegirl is saying some sort of rotation can make the zygomatic arch more prominent? I'm a bit confused now. could someone diagram this?

[falcao]

Perhaps celticcavegirl is right. What I may add is that that girl may have lost A LOT of weight post-surgery, as it usually happens. Even if as little as 5% of that weight loss is in the face, it will show hugely. It may have accentuated her already existing, good cheekbones.

What I'm trying to say, you have to account for soft tissue (especially subcutaneous fat) in this type of analysis. That's why I posted the case of Marco Mengoni. Look him up or watch one of his videos on youtube. He is the perfect example, an epitome for concave cheeks that we discuss here. Yet before his weight loss, he was the complete opposite of that - his face had no definition at all, and not even a hint of cheekbones or an S curve. Soft tissue thickness and distribution is crucial in looking good. You may be overanalysing the case of that woman - her transformation in the upper mid face and the better definition may be a simple case of big weight loss. Think also of professional athletes, one digit body fat percentage - watch any athletic championship and notice how so many of them have that concave cheeks look. Of course, it's not a bullet-proof method - soft tissue is not fat only and even if it is, some people may drop huge amounts of weight but still (genetically) retain the fat in their cheeks. But for many people, including Marco Mengoni, it works perfectly in transforming their faces from highly unattractive to highly attractive.

[Tiny]

What I am saying is that increasing the vertical dimension of the posterior face via maxillary rotation will stretch out the cheek fat and make the cheekbones appear much more prominent.    You see it in this girl and in that blonde girl.

 I can also see this result very clearly in myself - I have strongish cheekbones but quite fat cheeks, plus a deep bite.  If I close my bite, I don't have the S-curve; all the cheekfat is pushed up.  If I open the bite (but keep the mouth closed), then the concavity appears (as I'm increasing the vertical dimension and stretching out the tissue), and the cheekbone appears a lot more defined, but is actually the same size.  Does that make sense?


Lazlo, re: paleo -  I mainly eat meat, fish, vegetables and eggs.  I eat organic goat yoghurt, cheese and keffir sometimes (2 times a week?) after being non-dairy for 2 years (my ancestry is northern european/middle eastern/central asian so I feel it's not that bad for me).  I rarely eat rice but sometimes have a little sushi or tahdeg (this is the crispy bottom you make when cooking rice the persian way).   I used to be 100% strict, very low carb paleo but it f**ked up my thyroid (common in women) so now I'm about 15-20% carbs, 30-35% protein, 45-55% fat.   I never eat vegetable oils except coconut and raw olive oil, never eat legumes, never eat processed or junk food.   It was easier when I lived in london (quality of food in the gulf is poor and everything goes off in about 2 days)

A typical day might look like this
breakfast
2 eggs, + extra whites, square of 85% chocolate
lunch
sashimi, prawn, avocado and seaweed salad
dinner
chicken thighs, vegetables (I do have some carby root veggies like carrots, squash, parsnips as well as green veggies)

I'm quite little so don't need to eat a lot, about 1200-1500 cals a day (at the moment I don't exercise a lot after the kickboxing nose-breaking incident, I'm doing 2x hiphop dance class (90 mins) and 2x weights (30 mins) a week)

Paleo is expensive if you're bigger and have to eat 3000+ calories a day!

[Lazlo]

What I am saying is that increasing the vertical dimension of the posterior face via maxillary rotation will stretch out the cheek fat and make the cheekbones appear much more prominent.    You see it in this girl and in that blonde girl.

 I can also see this result very clearly in myself - I have strongish cheekbones but quite fat cheeks, plus a deep bite.  If I close my bite, I don't have the S-curve; all the cheekfat is pushed up.  If I open the bite (but keep the mouth closed), then the concavity appears (as I'm increasing the vertical dimension and stretching out the tissue), and the cheekbone appears a lot more defined, but is actually the same size.  Does that make sense?


Lazlo, re: paleo -  I mainly eat meat, fish, vegetables and eggs.  I eat organic goat yoghurt, cheese and keffir sometimes (2 times a week?) after being non-dairy for 2 years (my ancestry is northern european/middle eastern/central asian so I feel it's not that bad for me).  I rarely eat rice but sometimes have a little sushi or tahdeg (this is the crispy bottom you make when cooking rice the persian way).   I used to be 100% strict, very low carb paleo but it f**ked up my thyroid (common in women) so now I'm about 15-20% carbs, 30-35% protein, 45-55% fat.   I never eat vegetable oils except coconut and raw olive oil, never eat legumes, never eat processed or junk food.   It was easier when I lived in london (quality of food in dubai is poor and everything goes off in about 2 days)

A typical day might look like this
breakfast
2 eggs, + extra whites, square of 85% chocolate
lunch
sashimi, prawn, avocado and seaweed salad
dinner
chicken thighs, vegetables (I do have some carby root veggies like carrots, squash, parsnips as well as green veggies)

I'm quite little so don't need to eat a lot, about 1200-1500 cals a day (at the moment I don't exercise a lot after the kickboxing nose-breaking incident, I'm doing 2x hiphop dance class (90 mins) and 2x weights (30 mins) a week)

Paleo is expensive if you're bigger and have to eat 3000+ calories a day!

hey yes, that makes sense, i notice the same thing too when i open my bite but keep my mouth closed. so you're saying that if that rotation of the maxilla with advancement will produce that look even when your bite is closed? i have a lot of orbital rim deficiency i think so either my cheekbones need to go up higher on my face or i need the orbital rims advanced along the posterior axis, my width is fine. thanks for the paleo outline --i've switched to a very similar diet except one of my meals is a green smoothie with gluten free non gmo rice protein (i know not paleo technically, but it's too much cooking otherwise!).

[Tiny]

. so you're saying that if that rotation of the maxilla with advancement will produce that look even when your bite is closed?

In my case it might - because I've got a deep bite and vertical deficiency in the posterior face, but strong-ish cheekbones.  Rotation would open up the bite (I don't need advancement, and I know that girl says she had advancement but it mainly looks like rotation from the sketch)

I think you only really get the obvious result in short faces/deep bites that already have decent cheekbones

[PloskoPlus]

FWIW,

This guy's maxilla was advanced 9 freaking mm. 

http://youtu.be/2pb2QLQWQ-k

I think he's #10 from the bottom:
http://www.drwittenberg.com/photo-gallery/upper-jaw-gallery.html

IMO, looks better in the video than in the photo.

[Kristen]

Good results on that surgeons website.  Not in US though

[Tiny]

Quite nice ramus enlargement results.  Do we think it's paste or implants?

[Lord-of-the-Cartilage]

Quite nice ramus enlargement results.  Do we think it's paste or implants?

Who's ramus was enlarged?
So is there a consensus on whether advancing both jaws sacrifices cheek concavity?

[Lazlo]

Who's ramus was enlarged?
So is there a consensus on whether advancing both jaws sacrifices cheek concavity?

i don't think it necessarily does. i think people with initially shorter faces, they look better after bimax because the rotation and advancement of the maxilla makes the cheekbones pop more, whereas people with longer faces, (I THINK) sacrifice cheek concavity since the midface comes out more, instead of the top part. it's probably more complicated than that having to do with soft tissue variabilities etc. etc. honestly one top surgeon i talked to said it's really tough to predict how the undereye or cheekbone area will look after surgery --anyone who says they can predict is is bssing....though i wonder with the new 3D mri and imaging systems if they can get a bit closer....i don't think so honestly.

[pekay]

FWIW,

This guy's maxilla was advanced 9 freaking mm. 

http://youtu.be/2pb2QLQWQ-k

I think he's #10 from the bottom:
http://www.drwittenberg.com/photo-gallery/upper-jaw-gallery.html

IMO, looks better in the video than in the photo.

Yeah that is him (on the website you linked)

9mm is way too aggressive *imo*, his upper lip (philtrum) blew up in size. he looks good though.

[Tiny]

not really, this type of thing is REALLY easy to fix with fat grafting which has been concentrated with adipose stem cells. in fact, they're getting better and better at this all the time. this is the last thing to worry about. and also, i know several people who are guys in fact who have had these mini-face lifts and fat grafting done in their early 30s!

The doc who did my lip filler said that in women you begin to see volume loss between 28-33 onwards.  Rhino surgeon said the same.  In men, about 34 onwards

Aging is caused first by fat loss, second by wrinkles, gravity and loss of skin density and elasticity and thirdly by bone loss.

Fat loss and be improved with fillers and fat grafting (the latter being a lot better!)
Skin issues can be improved by lasers, peels and facelifts
Bone loss is pretty difficult to fix - it affects the entire facial skeleton.  But keeping healthy, full-size teeth is a good start