jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Optimistic on April 24, 2014, 08:56:52 PM
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Definitely one of my stupider posts here, but I was talking to some people about scleral show lately and it had me wondering about what was achievable with infraorbital rim augmentation.
Particularly, through a combination of bone grafting and fat transfers would it be possible to recreate the look I get when lightly squinting? It makes under my eyes have a bit more volume, eyes vertically narrower, and generally looks good. Seems like I wouldn't need much to achieve it, but I don't know if implants or anything else can create that 'look'.
Perhaps the use of some filler or fat transfer a la 'love band surgery' plus a modest amount of augmentation to make the eyes narrower would work.
(http://petapixel.com/assets/uploads/2013/11/squinchba4.jpg)
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Why don't you just squint more habitually?
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Why don't you just squint more habitually?
(http://i.imgur.com/iwUscHq.jpg)
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Why don't you just squint more habitually?
This is a serious question.
Unfortunately walking around squinting is not my first choice. If I could achieve this look surgically I'd prefer that.
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I don't recommend getting a fat transfer. Some reputable surgeons say that you can experience adverse effects after 5-10 years and it seems like a very difficult thing to get right in the first place judging by all the people with bad results I've seen. If the problem is the lack of bone support then any attempt to correct it without addressing the root of the problem seems like a bad idea to me.
I've looked into the matter myself and it seems that almost all surgeons prefer silicone implants. It's possible that Arnett and Gunson do it using HA grafts but I can't find anyone else that does.
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I don't recommend getting a fat transfer. Some reputable surgeons say that you can experience adverse effects after 5-10 years and it seems like a very difficult thing to get right in the first place judging by all the people with bad results I've seen. If the problem is the lack of bone support then any attempt to correct it without addressing the root of the problem seems like a bad idea to me.
I've looked into the matter myself and it seems that almost all surgeons prefer silicone implants. It's possible that Arnett and Gunson do it using HA grafts but I can't find anyone else that does.
That is what I've wondered myself. If HA or bone grafting could be used as an alternative to implants.
For all the maxfac surgeons who claim to be using the stuff I'm constantly amazed by how few results are out there. I've not really seen a single case which showed what augmentation with HA paste can do.
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depends on how bad your structure is. if its more than a few mm recessed your only option for real improvement is implants of a lefort ii which most docs wont do
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One option is a canthopexy with an enduragen or hard palate graft for support. This video explains
Detailed Surgery for Scleral Show but Advising Postponement for Young Lady (http://www.youtube.com/watch?v=ruOoE-dmXjg#ws)
Unfortunately, the raise of the lower lid isn't even and you'll wind up looking like you've had work done. Also, post-surgical inflammation lasts a very long time and sometimes never goes away at all so that the surgery needs to be reversed. I've consulted with Prasad myself in person and it didn't seem worth it to me.
I'm probably going to get orbital decompression which should improve my lower lid retraction (which is what causes scleral show).
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depends on how bad your structure is. if its more than a few mm recessed your only option for real improvement is implants of a lefort ii which most docs wont do
Earl,
How much scleral show do you have?
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depends on how bad your structure is. if its more than a few mm recessed your only option for real improvement is implants of a lefort ii which most docs wont do
I don't have scleral show at all. I just would like to have slightly narrower eyes with a bit of the puffiness underneath them. I figure that'd make things easier, no?
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One option is a canthopexy with an enduragen or hard palate graft for support. This video explains
Detailed Surgery for Scleral Show but Advising Postponement for Young Lady (http://www.youtube.com/watch?v=ruOoE-dmXjg#ws)
Unfortunately, the raise of the lower lid isn't even and you'll wind up looking like you've had work done. Also, post-surgical inflammation lasts a very long time and sometimes never goes away at all so that the surgery needs to be reversed. I've consulted with Prasad myself in person and it didn't seem worth it to me.
I'm probably going to get orbital decompression which should improve my lower lid retraction (which is what causes scleral show).
In other words, it's all about the bones.
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Has anyone seen any before/after pictures from Arnett and Gunson where they did infraortibal rim augmentation?
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Has anyone seen any before/after pictures from Arnett and Gunson where they did infraortibal rim augmentation?
Antbee got a great overall result: http://jawsurgeryforums.com/index.php/topic,303.75.html (http://jawsurgeryforums.com/index.php/topic,303.75.html)
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Antbee got a great overall result: http://jawsurgeryforums.com/index.php/topic,303.75.html (http://jawsurgeryforums.com/index.php/topic,303.75.html)
Incredible transformation.
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Antbee got a great overall result: http://jawsurgeryforums.com/index.php/topic,303.75.html (http://jawsurgeryforums.com/index.php/topic,303.75.html)
Meh she didn't look bad to begin with. I'm talking about eye bags due to negative vector cheeks and other bulls**t.
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Meh she didn't look bad to begin with. I'm talking about eye bags due to negative vector cheeks and other bulls**t.
Frankly I can't see much of a difference in terms of her eyes. Though the squint look I'm talking about doesn't work on women, so it's probably a good thing.
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One option is a canthopexy with an enduragen or hard palate graft for support. This video explains
Detailed Surgery for Scleral Show but Advising Postponement for Young Lady (http://www.youtube.com/watch?v=ruOoE-dmXjg#ws)
Unfortunately, the raise of the lower lid isn't even and you'll wind up looking like you've had work done. Also, post-surgical inflammation lasts a very long time and sometimes never goes away at all so that the surgery needs to be reversed. I've consulted with Prasad myself in person and it didn't seem worth it to me.
I'm probably going to get orbital decompression which should improve my lower lid retraction (which is what causes scleral show).
Rewatching this again it's interesting what he says about the cheeks. I believe I'll throw out the notion of infraorbital rim augmentation until I've had my chin wing and Malar osteotomy as there's a good chance I'll see chances in that area once the cheek bones are raised and augmented. If there are still any concerns I could look at addressing it via an implant or graft.
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What, no lefort iii?
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Meh she didn't look bad to begin with. I'm talking about eye bags due to negative vector cheeks and other bulls**t.
Go see an ophthalmologist, see if anything can be done with the soft tissue/fat redistribution/fillers.
I can vouch for this guy in London, he is one of the very best with a special interest in cosmetic, aesthetic work. He's meticulous, honest and a really nice bloke in general: http://www.ramanmalhotra.com/blepharoplasty.php
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Go see an ophthalmologist, see if anything can be done with the soft tissue/fat redistribution/fillers.
I can vouch for this guy in London, he is one of the very best with a special interest in cosmetic, aesthetic work. He's meticulous, honest and a really nice bloke in general: http://www.ramanmalhotra.com/blepharoplasty.php
It's not a soft issue problem and I've looked like this since I was a child basically so it's not age related either. I've studied a lot of before/after pictures and good results are very rare when only the soft tissue is addressed.
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It's not a soft issue problem and I've looked like this since I was a child basically so it's not age related either. I've studied a lot of before/after pictures and good results are very rare when only the soft tissue is addressed.
I hear you, addressing the underlying structure would be ideal but if that's not possible then a little camouflage action might help.
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It's not a soft issue problem and I've looked like this since I was a child basically so it's not age related either. I've studied a lot of before/after pictures and good results are very rare when only the soft tissue is addressed.
This is exactly how I feel too. I don't think it makes sense to be using fillers, fat grafts, and lifts to improve what is in essence a structural problem.
I'm going to ask Triaca what he does for infraorbital rims and report back.
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Rewatching this again it's interesting what he says about the cheeks. I believe I'll throw out the notion of infraorbital rim augmentation until I've had my chin wing and Malar osteotomy as there's a good chance I'll see chances in that area once the cheek bones are raised and augmented. If there are still any concerns I could look at addressing it via an implant or graft.
I'm also holding off fixing my eyes until I've recovered from another procedure (rhinoplasty in October). I'm probably just going to try filler at first as per these studies http://synapse.koreamed.org/DOIx.php?id=10.3341/jkos.2012.53.3.357&vmode=PUBREADER and attachment
Good luck on the chin wing. It was my dream to get a chin wing with Triaca or Zarrinbal, but I sadly had to abandon it and settle for a regular SG because my parents are paying for my surgeries and didn't really want me doing it in Europe.
[attachment deleted by admin]
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I'm also holding off fixing my eyes until I've recovered from another procedure (rhinoplasty in October). I'm probably just going to try filler at first as per these studies http://synapse.koreamed.org/DOIx.php?id=10.3341/jkos.2012.53.3.357&vmode=PUBREADER and attachment
Good luck on the chin wing. It was my dream to get a chin wing with Triaca or Zarrinbal, but I sadly had to abandon it and settle for a regular SG because my parents are paying for my surgeries and didn't really want me doing it in Europe.
Well that answers some of the questions I had after reading your other thread.
I'll be getting a chin wing and malar osteotomy with Triaca in the very near future. After that I'll assess the situation and probably consider a modest amount of forehead recontouring and call it quits.
I'm going to ask triaca if he offers some form of infraorbital rim augmentation using grafting. If he does then I'll try and get this done at the same time. I won't go out of my way to specifically address the issue, however. At least not yet.
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I consulted a doc about zygoma augmentation (with HA) and canthoplasty (my outer corners are droopy)
He said that augmenting the zygomatic arch will indeed support the eye area and reduce bags and droopyness of the eyes
I got fillers in the bags, stiff hyalauronic acid, deep under the skin and down near the bone. It helped the hollows but to be honest the eye shape looks pretty similar
Personally I think that to get the 'narrow eyes' (Almond eyes) look, a canthoplasty and/or lateral browlift is the most effective way
http://www.lidlift.com/procedures/midface <- this guy seems to do a lot of orbital rim implants
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Tiny,
That doc back pedalled on implants in recent years. Now offers them in special cases. otherwise, it's filler all the way. If his real self posts are anything to go by.
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Tiny,
That doc back pedalled on implants in recent years. Now offers them in special cases. otherwise, it's filler all the way. If his real self posts are anything to go by.
Yes, I e-consulted with that guy and he told me wouldn't perform surgery on me, only fillers. I know another person with my degree of scleral show (1-2 mm) who also consulted with him and his response was the same. He reserves surgery only for revision patients it seems.
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Tiny,
That doc back pedalled on implants in recent years. Now offers them in special cases. otherwise, it's filler all the way. If his real self posts are anything to go by.
Interesting. So many docs these days recommend fillers for absolutely everything and anything. IMO it's a bit of a racket and fillers as the perfect thing for docs to make tons of money from - needlessly expensive, low risk, and must be frequently repeated. That's why doctors get so defensive and start howling about when nurses or technicians inject, saying they're not capable, it's too difficult, blah blah blah. I get the feeling that some docs suggest fillers before anything else, repeat them a few times, and then when it doesn't fix the issue they finally agree to operate....after making $ doing several rounds of fillers
Not saying that fillers don't work, but they're more appropriate for some cases than others
The lady I see now for mine isn't a surgeon but she's great and I pay less than half of what I would in a surgeons office
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Interesting. So many docs these days recommend fillers for absolutely everything and anything. IMO it's a bit of a racket and fillers as the perfect thing for docs to make tons of money from - needlessly expensive, low risk, and must be frequently repeated. That's why doctors get so defensive and start howling about when nurses or technicians inject, saying they're not capable, it's too difficult, blah blah blah. I get the feeling that some docs suggest fillers before anything else, repeat them a few times, and then when it doesn't fix the issue they finally agree to operate....after making $ doing several rounds of fillers
Not saying that fillers don't work, but they're more appropriate for some cases than others
The lady I see now for mine isn't a surgeon but she's great and I pay less than half of what I would in a surgeons office
That's exactly what I felt when Paul Johnson kept bringing up lip fillers as the solution to my problem with the underprojected upper jaw. I would probably take the same stance myself if I was a doctor.
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That's exactly what I felt when Paul Johnson kept bringing up lip fillers as the solution to my problem with the underprojected upper jaw. I would probably take the same stance myself if I was a doctor.
IMO it's a bit cowardly. Like they don't have confidence in their own skill
I went to a doc who was supposedly one of the best in town to discuss revision rhino. He didn't want to operate because it was "difficult" and told me just to get fillers in the bridge to balance the scooped out bridge and the large tip.
However, 4 other docs had no issue. Two said to get a graft and two said just to reduce the tip cartilages.
Having said that, the thin skin in the eye areas makes implants tricky, especially over time. I've seen cheek implants that after 10 years looked BAD
Anyway, I don't think that implants are the best thing for getting narrower eyes, anyway.
Posko, I think you have a quite heavy brow? If you get canthoplasty alone then your eyes could end up tiny but canthoplasty combined with a temporal browlift could give a nice result....if you want to go down the PS route.
Personally I have quite saggy eye corners and I just get botox to raise the brow about 2mm and then put black eyeliner in the waterline of the outer corner, an white eyeliner on the inside coner
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Having said that, the thin skin in the eye areas makes implants tricky, especially over time. I've seen cheek implants that after 10 years looked BAD
I've heard the same thing about fat grafts. In general, I think it's a bad idea to mess around with the soft tissue. I happen to have very thin skin in the eye area so I have to be extra careful when I consider what procedures would work well for me.
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I've heard the same thing about fat grafts. In general, I think it's a bad idea to mess around with the soft tissue. I happen to have very thin skin in the eye area so I have to be extra careful when I consider what procedures would work well for me.
Agreed. Fat grafts are not advised in the eye area. I think for cheeks it's OK but for eyes, nope. One of the good things about hyalauronic fillers is that they can be removed if necessary. And the issue with implants in the eye area is that the skin is so thin, there is little camouflage
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Posko, I think you have a quite heavy brow? If you get canthoplasty alone then your eyes could end up tiny but canthoplasty combined with a temporal browlift could give a nice result....if you want to go down the PS route.
I wouldn't say that my brow ridge it's neanderthalic, but it's significant. Before I even knew what a maxilla was, I always thought that my eyes are small relative to my face - big temples, a broad and longish midface. My surgeon said that building up under the eyes will make them look "too squinty". I'm reluctant to admit it, but I think he has a better understanding of aesthetics than I have been giving him credit for. For when I look in the mirror from about 3 meters, my eyes are dominated by the surrounding brow ridge, temples, big face. The eye bags, slight scleral show becomes unnoticeable. Though, IMO, small gun-slit eyes look better than small "sleepy eyes".
I'm not sold on manipulating the soft tissue to fix eyes, especially when the problem is structural, rather than age-related. IMO, beautiful eyes cannot be achieved surgically.
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Most plastic surgeons will tell you that aging related cosmetic problems are the result of the natural loss of bone substance in the face that happens as you age. It's very obviously a structural problem so I don't understand why anyone would think it makes sense to try to rearrange the soft issue to cover it up. Those of us with underdeveloped midfaces get all those problems for free that are normally associated with aging.
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Most plastic surgeons will tell you that aging related cosmetic problems are the result of the natural loss of bone substance in the face that happens as you age.
Really? I thought it was a relatively new discovery that facial bones shrink with age, and the common wisdom was that it's all soft tissue.
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Really? I thought it was a relatively new discovery that facial bones shrink with age, and the common wisdom was that it's all soft tissue.
How recent could that be?
The average person would likely be unaware of shrinkage in facial bones, though ironically this is almost entirely responsible for our perception of age in other people - not skin.
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How recent could that be?
The average person would likely be unaware of shrinkage in facial bones, though ironically this is almost entirely responsible for our perception of age in other people - not skin.
I would say 10 years.
http://blogs.webmd.com/cosmetic-surgery/2010/05/our-face-sags-and-facial-bones-shrink.html
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I would say 10 years.
http://blogs.webmd.com/cosmetic-surgery/2010/05/our-face-sags-and-facial-bones-shrink.html
What do you think this means for someone in their 50's? Should they be using radiesse to compensate for shrinking bone?
Would whole face HA paste be another possibility? Implants?
What can be done to augment the facial bone structure back to a youthful state?
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What do you think this means for someone in their 50's? Should they be using radiesse to compensate for shrinking bone?
Would whole face HA paste be another possibility? Implants?
What can be done to augment the facial bone structure back to a youthful state?
Well, this guy is building his whole business on HA paste "rejuvenation".
http://bmendelson.com.au/
Though, IMO, skin condition is also very important (elasticity, sun damage).
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IMO, beautiful eyes cannot be achieved surgically.
Agree
Well, this guy is building his whole business on HA paste "rejuvenation".
http://bmendelson.com.au/
Though, IMO, skin condition is also very important (elasticity, sun damage).
Smart guy. I think in the next 5 years we are going to see a lot more surgeons going down this route. So far the focus has been on sagging skin and tissues (facelifts/browlifts), loss of soft tissue volume (fillers) and skin condition (lasers, peels, make-up) and you do see some surgeons adding chin and cheek implants to make up for the lost bone. But now they're getting an understanding of bone loss over time, the use of HA paste is going to become more prevalent
Generally most surgeons focus on anti-aging procedures more than beautification. There are few that focus on the latter and they tend to do more things like jaw/malar augmentation, temporal browlifts etc
I got a quote off one of the only European surgeons doing HA augmentation and it was 4,500eur for cheekbones. Probably going to wait and get it done when I get my jaw surgery
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I got a quote off one of the only European surgeons doing HA augmentation and it was 4,500eur for cheekbones. Probably going to wait and get it done when I get my jaw surgery
Was that Mommaerts? I thought HA sounded good in theory at first but my own experience with it along with what Triaca supposely said about it makes me hesitant to have anything to do with it for the purpose of sculpturing the face.
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Was that Mommaerts? I thought HA sounded good in theory at first but my own experience with it along with what Triaca supposely said about it makes me hesitant to have anything to do with it for the purpose of sculpturing the face.
Exactly my thoughts.
In theory HA paste is ideal for bone rejuvination, as Tiny puts it. Unfortunately, in the event I didn't misunderstand Triaca then that means HA paste would be counter-productive and very dangerous when applied in such a fashion. Of course, there's always bone grafting however that too has drawbacks. Namely that it acts exactly like real bone and will recede over time.
I wonder if this just leaves implants for now?
I have to say that I just don't 'get' how HA paste can do what Triaca is claiming. Hydroxyapatite is really just coral granules of which 80% of natural bone is comprised of. How could it cause erosion of bone? Why can't I find any studies to confirm this? All show long-term stability.
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Well, this guy is building his whole business on HA paste "rejuvenation".
http://bmendelson.com.au/
Though, IMO, skin condition is also very important (elasticity, sun damage).
This is absolutely true, however to a point won't alter much of your perceived age. It'll make someone look some years younger (particularly as you get into advanced age), though ultimately it's going to make them look BETTER for their age.
Our perception of age is heavily associated with bone loss. How is it that someone caked in make-up and airbrushed with perfect skin will always look around their age? It's not like we can simply airbrush the face of a 40yo and suddenly we confuse them for a 20-something girl. Reason being bone loss leads to the loss of a triangular face shape, less facial fat, narrower midface, all those things give the perception of age.
It's also why attractive people 'age better'. They have more bone to lose and thus retain youthful features and appearance for longer.
my two cents.
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This is absolutely true, however to a point won't alter much of your perceived age. It'll make someone look some years younger (particularly as you get into advanced age), though ultimately it's going to make them look BETTER for their age.
Our perception of age is heavily associated with bone loss. How is it that someone caked in make-up and airbrushed with perfect skin will always look around their age? It's not like we can simply airbrush the face of a 40yo and suddenly we confuse them for a 20-something girl. Reason being bone loss leads to the loss of a triangular face shape, less facial fat, narrower midface, all those things give the perception of age.
It's also why attractive people 'age better'. They have more bone to lose and thus retain youthful features and appearance for longer.
my two cents.
I agree in part but not completely. There are many things that contribute to ageing. One of the most major things is loss of contrast in the face. Over time, the skin gets darker and everything else gets lighter. That's why makeup works - I think she looks a lot younger with makeup
http://www.maskcara.com/2013/01/07/age-is-beauty/ (http://www.maskcara.com/2013/01/07/age-is-beauty/)
IMO the most aging things, facially, are - jowls, marionette lines and sagging mouth corners, followed by sagging brows and eye corners. However it is true that a weak bone structure will make these things much worse. I am already seeing sagging in the mid and lower face because of weak bone structure :o
I wonder who ages worse - class 2s (with the underdeveloped mandible) or class 3s with the underdeveloped midface?
It will be interesting to see how this field develops over the next 10 years or so. There are already a lot of techniques to address most aspects of ageing but bone degradation is something that is something that has so far, been pretty overlooked. Ironically, I think some of the advances we are going to see in jaw surgery over the next 10-20 years will originally come from anti-aging cosmetic surgery and then get adopted by orthognathic surgeons. Simply because there are far more cosmetic surgeons vs jaw surgeons, the demand for anti-aging surgery is so high, and a 50 year old usually has more money than a <30 year old
Combination procedures - browlift, bleph + canthoplasty, midface lift
(https://scontent-a.xx.fbcdn.net/hphotos-xaf1/t1.0-9/393551_241969295856147_626113439_n.jpg)
(https://scontent-b.xx.fbcdn.net/hphotos-xpf1/t1.0-9/311866_241969365856140_183815150_n.jpg)
Canthopexy (but done with an awful and unnecessary browlift!!!)
(http://www.flowersclinic.com/gallery/New-Patient-Photo-33-Mag-5.jpg)
Canthopexy
(https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcR1De_Ry7A8ZVb52_FOrvX3mB5SnNj_BqnwhbiyYX9BU4ss_5yt)
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Some of you seem to forget that Brad Pitt is 50 years old and still looks great. At what age is it okay to start looking old according to you people?
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IMO also. Sure facial bones shrink, but their contribution to aging is surely less than that of soft tissues. Maybe the solution is to sleep upside down to undo the effects of gravity... or to live in space.
BTW, apparently hips widen with age (the bones).
If what you're saying is true, why does an airbrushed 40 year old still look 40? Shouldn't their perceive age be 20 or so?
Looking better for your age (good skin) =! looking younger than your age
Preventing and restoring bone loss is everything when it comes to looking younger than one's biological age. Fat loss and skin quality - whilst extremely important - will not address the fundamental issues which cause one to be perceived as older.
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Another thing I'd like to address is people in this thread trying to make generalizations about what is and isn't possible based on society's 50 plus people.
How many were using photostable sunscreen that blocked almost all UVA since a very young age? Nothing of the sort even existed. They likely grew up believing a tan was healthy.
How many knew about proper nutrition and supplementation to prevent various functions of ageing and telomere shortening? Again, none of this ever existed.
No living person who could be considered old has ever been able to implement the necessary steps required to truly prevent ageing to a significant degree. So there is very little that can be drawn from these examples other than what I've stated above.
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The role of bone shrinkage in the aging process was overlooked for years. There's definitely more to it than simply the effects of gravity, that's why simply hoisting the skin up in a facelift doesn't make you look 'young', just a bit odd in most cases.
http://www.livescience.com/35332-face-bones-aging-110104.html
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The role of bone shrinkage in the aging process was overlooked for years. There's definitely more to it than simply the effects of gravity, that's why simply hoisting the skin up in a facelift doesn't make you look 'young', just a bit odd in most cases.
http://www.livescience.com/35332-face-bones-aging-110104.html
Bleak. But how does science explain Gwen Stefani? I hope I age like her aka not at all.
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Bleak. But how does science explain Gwen Stefani? I hope I age like her aka not at all.
Makeup. Lots of it.
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The role of bone shrinkage in the aging process was overlooked for years. There's definitely more to it than simply the effects of gravity, that's why simply hoisting the skin up in a facelift doesn't make you look 'young', just a bit odd in most cases.
http://www.livescience.com/35332-face-bones-aging-110104.html
"Although these changes occurred in both sexes, many occurred earlier in women between young and middle age. In men, most of the changes occurred between middle age and old age."
Typical. All the more reason to marry a guy 10+ years older than you (I guess the downside is that he is likely to die 15 years before you)
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"Although these changes occurred in both sexes, many occurred earlier in women between young and middle age. In men, most of the changes occurred between middle age and old age."
Typical. All the more reason to marry a guy 10+ years older than you (I guess the downside is that he is likely to die 15 years before you)
Would that be really a downside if he's rich?
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Would that be really a downside if he's rich?
I'd imagine that losing your partner would be pretty devastating unless you're a gold digger. Finding a new partner that late in life is probably very hard as well so that money isn't going to do you much good.
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Would that be really a downside if he's rich?
Even if he's poor, you'd probably be sick of the sight of each other by that stage anyway ;D
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I'd imagine that losing your partner would be pretty devastating unless you're a gold digger. Finding a new partner that late in life is probably very hard as well so that money isn't going to do you much good.
Not if he is 25 years older.
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Even if he's poor, you'd probably be sick of the sight of each other by that stage anyway ;D
I thought I was cynical... This is actually why I hesitate to get involved with someone because a lot of couples seem to stop being attracted to each other after a while. Being average or below average looking will surely not help in that regard. This is the exact type of relationship I want to avoid:
https://www.youtube.com/watch?v=8EwU2VPKK0M
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I thought I was cynical... This is actually why I hesitate to get involved with someone because a lot of couples seem to stop being attracted to each other after a while. Being average or below average looking will surely not help in that regard. This is the exact type of relationship I want to avoid:
https://www.youtube.com/watch?v=8EwU2VPKK0M
Ha, the single life is definitely preferable to that for sure!
The initial rip each clothes off, can't get enough of each other stuff fades to something more manageable for everybody, regardless of the level of physical attraction involved. I suppose decades of f**king the same person can either be incredible tedious or reassuringly comfortable, depending on your relationship - the cosy, companionship side of it is actually quite appealing.
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Ha, the single life is definitely preferable to that for sure!
(http://img.4plebs.org/boards/pol/image/1385/77/1385779913511.gif)
"Haha, yeeessss good goys... I mean boys and girls. Marriage and families suck! Stay single. If you want happiness try buying the new iPhone that came out!"
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This is actually why I hesitate to get involved with someone because a lot of couples seem to stop being attracted to each other after a while.
It's evolutionary. Over time, most women generally become less and less attracted to their partner (there are actually studies on this) It does make sense, of course - where's the evolutionary advantage to having 6 kids with the same guy? There isn't one. Biologically, as a species, we are just not really wired for lifelong monogamy
It's actually pretty upsetting, to love someone and want to want them, but your body is like "meh, whatever". Generally with men, although after time they want some variety, they do still retain a decent amount of desire for their partner.
I guess the solution is to accept the reality and not base what you plan to be a long-term partnership on sex. A lot of people could stand to more pragmatic about this. Marriage is a compromise - and normally if you want the stability, the emotional support, the kids, the shared income, the partnership etc then you have to sacrifice the fireworks. People tend to want to have their cake and eat it in this regard when in reality, it really doesn't work that way. If and 'exciting' sex life is more important to a person than companionship and a family, then stay single. If you want a family, then accept the compromises that you have to make. Different people are going to have different priorities in this regard.
Would that be really a downside if he's rich?
I've dated rich guys and I find it can set up the kind of power imbalance I really don't get on with. I'd rather make and spend my own money than spend someone elses. But I'm the kind of person who really cannot stand being told what to do by anyone
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This is the best thread ever.
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I hate to be the first one to return to original topic, but has anyone here had orbital rim augmentation? Or have examples?
I'm thinking about consulting with Dr. Yaremchuk about this as he is the only one with examples and specifically discusses this procedure. Going in through the eyelid seems a bit risky, and I'm pretty sure that's the only option for this type of thing.
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I hate to be the first one to return to original topic, but has anyone here had orbital rim augmentation? Or have examples?
I'm thinking about consulting with Dr. Yaremchuk about this as he is the only one with examples and specifically discusses this procedure. Going in through the eyelid seems a bit risky, and I'm pretty sure that's the only option for this type of thing.
Can be done intra orally. Eppley has an article on this. Eppley has an article on everything.
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I hate to be the first one to return to original topic, but has anyone here had orbital rim augmentation? Or have examples?
I'm thinking about consulting with Dr. Yaremchuk about this as he is the only one with examples and specifically discusses this procedure. Going in through the eyelid seems a bit risky, and I'm pretty sure that's the only option for this type of thing.
Person above answered this, but eppley does it. He has articles on HA paste, various implant types.
Going in through the eyelid is easier, however intraoral is also possible.
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Eppley would probably make a fantastic professor with his knowledge but it feels like he does every plastic procedure under the sun so I can't imagine that he's good at even half of them since he doesn't get the benefit of specialization.
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Eppley would probably make a fantastic professor with his knowledge but it feels like he does every plastic procedure under the sun so I can't imagine that he's good at even half of them since he doesn't get the benefit of specialization.
I was under the impression that Eppley has a good name for himself in the plastic surgery community. Unless I'm mistaken I'd be surprised if his work wasn't of a high standard.
Someone who's more into that 'scene' is welcome to correct me.
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Eppley would probably make a fantastic professor with his knowledge but it feels like he does every plastic procedure under the sun so I can't imagine that he's good at even half of them since he doesn't get the benefit of specialization.
Epply does not write his articles. He has someone hired to do them for him.
I don't think he's highly regarded among his peers. I'm not saying he's at the bottom of the food chain either, but he isn't one of those docs who's considered "it" among his peers. He's just very good at self promotion.
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I think aging is not a matter of bones or skin, it's bone, skin and everything in between: muscles, retaining ligamengs, fat. It's a multifactorial thing that experience aging as time goes by. My own obsevation also is that aside from the sagging issue, our faces lose fat in some places but gain them in others, changing the entire face shape with time. Grafting some fat in the places where it's been lost is not enough as there are some places where the fat hypertrophies such as the double chin. It's all one giant clusterf**k and our best bet is for us to slow it down as much as we could with nutrition, supps, lifestyle...etc because so far no doctor can make a 50 year old pass as a 20 year old, and judging from the path anti-aging plastic surgery is currently taking; I don't think it's happening anytime soon, either.
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orbital rim deficiency imo is probably one of the hardest things to fix. there are very few options out there. the only thing that's probably harder is a supra orbital rim deficiency or farhead issue.
I have only seen one eppley orbital rim implant result (atleast I think it was his, it was on his blog). it was ok
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orbital rim deficiency imo is probably one of the hardest things to fix. there are very few options out there. the only thing that's probably harder is a supra orbital rim deficiency or farhead issue.
I have only seen one eppley orbital rim implant result (atleast I think it was his, it was on his blog). it was ok
I've been doing a lot of research on this and have consulted with Eppley and Yaremchuk. It seems like what makes an orbital rim deficiency such a difficult problem to fix is that, unlike jaw surgery, these doctors are essentially just eyeballing it. Really, the closer one matches the target problem (using preformed implants), the better I suppose. Atleast with jaw surgery you get to see your plan - they show you exact measurements and details. Custom implants I don't know much about, but the cost is prohibitive for me.
I've come to the conclusion that there is only one preformed infraorbital rim implant that is worthwhile to pursue: the Medpor one Yaremchuk has shown on his website (can also be seen on the Stryker Medpor site). Most surgeons seem to insist on using Silicone, yet this one only comes in Medpor. I asked Eppley if there's any science to modifying (carving?) these to fit each case. He said he does so on 90% of facial implants, but there is no science to it, just an 'artistic eye'. But really, just eyeballing it and trimming it down? Not sure how much confidence I have in its accuracy.
What's kinda depressing is that 3d printing technology could soon make custom models and implants very affordable. I just don't see it happening in the next few years, which is when I'd like consider this procedure.
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I've been doing a lot of research on this and have consulted with Eppley and Yaremchuk. It seems like what makes an orbital rim deficiency such a difficult problem to fix is that, unlike jaw surgery, these doctors are essentially just eyeballing it. Really, the closer one matches the target problem (using preformed implants), the better I suppose. Atleast with jaw surgery you get to see your plan - they show you exact measurements and details. Custom implants I don't know much about, but the cost is prohibitive for me.
I've come to the conclusion that there is only one preformed infraorbital rim implant that is worthwhile to pursue: the Medpor one Yaremchuk has shown on his website (can also be seen on the Stryker Medpor site). Most surgeons seem to insist on using Silicone, yet this one only comes in Medpor. I asked Eppley if there's any science to modifying (carving?) these to fit each case. He said he does so on 90% of facial implants, but there is no science to it, just an 'artistic eye'. But really, just eyeballing it and trimming it down? Not sure how much confidence I have in its accuracy.
What's kinda depressing is that 3d printing technology could soon make custom models and implants very affordable. I just don't see it happening in the next few years, which is when I'd like consider this procedure.
The non syndrome lefort iii paper I have says pretty much the same thing. ( Ok, It's 20 years old, but still...) Cephalometric analysis does not apply... It's a judgement call.
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orbital rim deficiency imo is probably one of the hardest things to fix. there are very few options out there. the only thing that's probably harder is a supra orbital rim deficiency or farhead issue.
I have only seen one eppley orbital rim implant result (atleast I think it was his, it was on his blog). it was ok
I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.
[attachment deleted by admin]
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I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.
Great improvement in the eyes. But why scoop out his nose like that?
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There's no telling what those implants will look like in 10 years. Those scars are definitely not acceptable to me.
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I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.
this guy later ruined his face with fat grafts an dr y had to carve them out.
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I've been doing a lot of research on this and have consulted with Eppley and Yaremchuk. It seems like what makes an orbital rim deficiency such a difficult problem to fix is that, unlike jaw surgery, these doctors are essentially just eyeballing it. Really, the closer one matches the target problem (using preformed implants), the better I suppose. Atleast with jaw surgery you get to see your plan - they show you exact measurements and details. Custom implants I don't know much about, but the cost is prohibitive for me.
I've come to the conclusion that there is only one preformed infraorbital rim implant that is worthwhile to pursue: the Medpor one Yaremchuk has shown on his website (can also be seen on the Stryker Medpor site). Most surgeons seem to insist on using Silicone, yet this one only comes in Medpor. I asked Eppley if there's any science to modifying (carving?) these to fit each case. He said he does so on 90% of facial implants, but there is no science to it, just an 'artistic eye'. But really, just eyeballing it and trimming it down? Not sure how much confidence I have in its accuracy.
What's kinda depressing is that 3d printing technology could soon make custom models and implants very affordable. I just don't see it happening in the next few years, which is when I'd like consider this procedure.
problem is its very hard to remove medpor. also the medpor implant is only like 2-3 mm so if u have a major deficiency it wont do much.
dr y now uses silicone covered in goretex
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There's no telling what those implants will look like in 10 years. Those scars are definitely not acceptable to me.
very true. as you age an orbital rim implant will show
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problem is its very hard to remove medpor. also the medpor implant is only like 2-3 mm so if u have a major deficiency it wont do much.
dr y now uses silicone covered in goretex
I'm not sure where you get your info, but Dr. Y just e-mailed me this morning with this reply:
The implants are made of porous polyethylene (Medpor)
As far as the scars are concerned, I will have to ask about this. In some cases it seems worse than others, but this is hopefully just a matter of how long these photos were taken post-op?
The issue of the implants showing isn't that much of a concern to me. Based on this photo the seams are pretty well flush with the bone.:
(https://dl.dropboxusercontent.com/u/59152504/medpor.jpg)
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I'm not sure where you get your info, but Dr. Y just e-mailed me this morning with this reply:
The implants are made of porous polyethylene (Medpor)
As far as the scars are concerned, I will have to ask about this. In some cases it seems worse than others, but this is hopefully just a matter of how long these photos were taken post-op?
i got it from him when i consulted with him although we only spoke about custom
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What are the chances of being able to get ahold of a sample of one of these Medpor implants you think? It could even be a digital model.
I have a recent CT scan from Gunson, which I could use to make a very accurate full scale 3D print (of my skull) for ~$20. I also have a new Xbox Kinect Sensor which could be used to make accurate scans of my face. All of these things could be superimposed to see some sort of end result.
It bothers me that this technology isn't being used more frequently. It's cheap to produce, highly accurate, and complements the 'artistry' side of surgery. Sound weird or too far to go for this sort of thing?
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What are the chances of being able to get ahold of a sample of one of these Medpor implants you think? It could even be a digital model.
I have a recent CT scan from Gunson, which I could use to make a very accurate full scale 3D print (of my skull) for ~$20. I also have a new Xbox Kinect Sensor which could be used to make accurate scans of my face. All of these things could be superimposed to see some sort of end result.
It bothers me that this technology isn't being used more frequently. It's cheap to produce, highly accurate, and complements the 'artistry' side of surgery. Sound weird or too far to go for this sort of thing?
didn't you have your lower orbitals augmented with HA back when you had jaw surgery?
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didn't you have your lower orbitals augmented with HA back when you had jaw surgery?
Gunson did no HA on me, which I think I'm glad he didn't. There was another patient I was talking to who said Gunson just sporadically added the HA procedure on at the end - I speculated whether that would happen with me. That's about as far as I got talking about HA and Gunson.
But taking this a little further, I think it's important to note that A&G don't do any orbital rim augmentation. The HA procedures they offer specifically target the midface/cheek/zygomatic arch - that sort of thing. In my last visit with Gunson, he told me to give him an update on what I decide to do about this.
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I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.
Does this also mean that canthoplexy is legit for fixing "Stallone" eyes?
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this guy later ruined his face with fat grafts an dr y had to carve them out.
Do you have a link to that? I'd be very curious to see how he ruined his face.
Eppley is now recommending fat grafts btw
http://www.exploreplasticsurgery.com/2014/06/28/fat-injections-for-lower-eyelid-retraction/
and two studies
http://www.ncbi.nlm.nih.gov/pubmed/24814272
https://asps.confex.com/asps/2007am/techprogram/paper_12676.htm
I've researched a lot and have pretty much concluded that none of the options are worth the risk at least for me. Maybe fillers are OK (http://www.ncbi.nlm.nih.gov/pubmed/17881981), but I'm even somewhat wary of the potential complications of those.
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I'm not sure where you get your info, but Dr. Y just e-mailed me this morning with this reply:
The implants are made of porous polyethylene (Medpor)
As far as the scars are concerned, I will have to ask about this. In some cases it seems worse than others, but this is hopefully just a matter of how long these photos were taken post-op?
The issue of the implants showing isn't that much of a concern to me. Based on this photo the seams are pretty well flush with the bone.:
(https://dl.dropboxusercontent.com/u/59152504/medpor.jpg)
I read they can be placed intraorally. Why not just opt to have it done that way?
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Gunson did no HA on me, which I think I'm glad he didn't. There was another patient I was talking to who said Gunson just sporadically added the HA procedure on at the end - I speculated whether that would happen with me. That's about as far as I got talking about HA and Gunson.
But taking this a little further, I think it's important to note that A&G don't do any orbital rim augmentation. The HA procedures they offer specifically target the midface/cheek/zygomatic arch - that sort of thing. In my last visit with Gunson, he told me to give him an update on what I decide to do about this.
Any reason you're glad about that? HA paste seems like an acceptable material for HA augmentation.
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I read they can be placed intraorally. Why not just opt to have it done that way?
I'm not sure what you've been reading, but even Eppley said they have to be placed through the eye. And this makes sense, it'd be a mess trying to place and screw in these implants from below. Link (5th paragraph): http://www.exploreplasticsurgery.com/2009/12/27/orbital-rim-implants-for-periorbital-rejuvenation-and-improving-facial-convexity/
I'm glad I didn't do the HA through Gunson because it wouldn't have been an orbital rim augmentation. I don't think I need anything other than that. Not really saying anything bad about HA.
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I'm not sure what you've been reading, but even Eppley said they have to be placed through the eye. And this makes sense, it'd be a mess trying to place and screw in these implants from below. Link (5th paragraph): http://www.exploreplasticsurgery.com/2009/12/27/orbital-rim-implants-for-periorbital-rejuvenation-and-improving-facial-convexity/
I'm glad I didn't do the HA through Gunson because it wouldn't have been an orbital rim augmentation. I don't think I need anything other than that. Not really saying anything bad about HA.
What would it have been? I don't get it.
Sucks about the scarring then too.
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(http://jawsurgeryforums.com/index.php?action=dlattach;topic=3750.0;attach=1380;image)
http://jawsurgeryforums.com/index.php?action=dlattach;topic=3750.0;attach=1380;image
What surgery was done on his jaw? I think his jaw was much better before, is it only lighting?
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He could have simply gained weight.
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(http://jawsurgeryforums.com/index.php?action=dlattach;topic=3750.0;attach=1380;image)
http://jawsurgeryforums.com/index.php?action=dlattach;topic=3750.0;attach=1380;image
What surgery was done on his jaw? I think his jaw was much better before, is it only lighting?
Here is the link to what they did and where they placed the jaw implants http://www.dryaremchuk.com/english/facial_contour.php
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Reviving this thread. Are there any minimally invasive suggestions for fixing ‘Stallone eyes’? I was thinking of an injectible filler. Can HA paste be injected without full surgery?
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Reviving this thread. Are there any minimally invasive suggestions for fixing ‘Stallone eyes’? I was thinking of an injectible filler. Can HA paste be injected without full surgery?
Wow, I was really active on this subject all these years ago...
I haven't really kept up with this subject, but I seriously doubt much has changed. HA paste would be used for extremely mild improvement at best. To get a nice smooth shape like an implant, you'd need some kind of robot surgeon that could see subdermally and essentially 3d print it under there...
Just for the record, I have abandoned the idea of orbital rim implants for myself. I find the idea of placing a foreign object through my eyelid horrific, and will just live with my ghoulish eyes for now.
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I am not keen on eye surgery either but sceral show is srs. I was thinking they could inject the HA paste or some kind of filler instead?
Dr Y does something called a lateral canothepexy to tighten the tendons and remove excess skin. I’ve read of people having Botox injections to try and achieve a positive effect but I am not sure how successful it is.
I have always had a bit of white showing under my iris but it’s got worse as I’ve gotten older. I also use daily contact lenses and that may exacerbate it.
I’ll update the thread with anything I find.
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I am not keen on eye surgery either but sceral show is srs. I was thinking they could inject the HA paste or some kind of filler instead?
Dr Y does something called a lateral canothepexy to tighten the tendons and remove excess skin. I’ve read of people having Botox injections to try and achieve a positive effect but I am not sure how successful it is.
I have always had a bit of white showing under my iris but it’s got worse as I’ve gotten older. I also use daily contact lenses and that may exacerbate it.
I’ll update the thread with anything I find.
HA 'paste' or granules for that matter is not injected. It is overlayed via a surgery for which there is an incision to do so. Radiesse, which is an injectable with HA particles suspended in a gel like matrix can be injected. But under the eye is NOT a good place for it to be injected. Under THICK tissue is better in the event there are lumps which would be less visible under thick tissue.
BOTOX is often used to reduce DYNAMIC wrinkles--like crows feet--aka 'smile lines' to the sides of eyes. NOT something you want to do if your objective is to SQUINT more. Why? Because the SAME muscles used for smiling are used to squint.
As to Dr. Y's cantho procedure, it would depend on whether or not your scleral show was attributable to lack of midface support in the orbital rim area. If that were the case, the cantho procedure would be done in conjunction with orbital rim implants WITH midface lift to suspend the soft tissue and hoist it upwards to attach to the implants.
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HA 'paste' or granules for that matter is not injected. It is overlayed via a surgery for which there is an incision to do so. Radiesse, which is an injectable with HA particles suspended in a gel like matrix can be injected. But under the eye is NOT a good place for it to be injected. Under THICK tissue is better in the event there are lumps which would be less visible under thick tissue.
BOTOX is often used to reduce DYNAMIC wrinkles--like crows feet--aka 'smile lines' to the sides of eyes. NOT something you want to do if your objective is to SQUINT more. Why? Because the SAME muscles used for smiling are used to squint.
As to Dr. Y's cantho procedure, it would depend on whether or not your scleral show was attributable to lack of midface support in the orbital rim area. If that were the case, the cantho procedure would be done in conjunction with orbital rim implants WITH midface lift to suspend the soft tissue and hoist it upwards to attach to the implants.
Thanks, great knowledge and clarity as always. I will set up a consultation in London and see what they say. Can anyone recommend any other oculaplastic surgeons in Europe?
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Any recommendations for a occularplastic surgeon in Europe? Does Dr Zarrinbal do this work? Pretty sure I need this more than jaw surgery.
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I had a promising consultation. I went in thinking about infraorbital implants and canthoplasty but the surgeon said I could probably achieve the look I want (no scleral show) by releasing some of the skin in the lower lid.
I will still have negative vector eyes, but I am thinking some filler under the eye could bring it out a bit. Any thoughts?
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I had a promising consultation. I went in thinking about infraorbital implants and canthoplasty but the surgeon said I could probably achieve the look I want (no scleral show) by releasing some of the skin in the lower lid.
I will still have negative vector eyes, but I am thinking some filler under the eye could bring it out a bit. Any thoughts?
to which surgeon you went? i recently read a lithuanian surgeon offers this kind of surgery for little name but unfortunately the exact name wasnt mentioned
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Just for the record, I have abandoned the idea of orbital rim implants for myself. I find the idea of placing a foreign object through my eyelid horrific, and will just live with my ghoulish eyes for now.
Why didn't you try fillers?