jawsurgeryforums.com
General Category => Emotional Support => Topic started by: screwsandplates on June 11, 2015, 05:25:54 PM
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I had double jaw surgery and a genioplasty last January, and love how it looks in profile. I don't regret doing it, but...
The only problem is my cheeks. My malar fat pads to be exact. They sag and look/feel very puffy, kind of like this (not quite as severe) (http://www.jcadonline.com/wp-content/uploads/funt1.jpg)
I'm guessing it is from having bone removed and nothing to support it. I'm only 21 years old but I look like I'm in my mid 30's D:
Should I talk to my surgeon about it? Last time I saw him and expressed my concern, he said that it was merely swelling. I don't think it is swelling anymore, as it has been a very long time since my operation, the puffiness is soft, and it looks amazing when I lie on my back (which would indicate sagging tissue). What are my surgical options? Has this happened to anybody else?
I'm trying to explain my concerns to my mom, and she says that filler will fix it. I don't see the point of adding volume to an already puffy face. I would rather lift the volume back to where it belongs.
Rant over.
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Strange... My lf1 picked up all the loose skin around my mouth, nasal base. 8 months post op.
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Why do these doctors blame "volume loss" for everything.
The woman has too much volume in her mid face, which has dropped... hence the "hound" look.
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ragirl: I agree.
My surgeon impacted my upper jaw, moved it forward, and performed a counter clockwise rotation. The lower jaw and chin were also advanced.
I thought it was just a regular le fort 1, but maybe it wasn't because there is a screw just by my nose/inner eye socket.
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I see this sometimes so it's not rare by any means. There's a good example in Reyneke's book about this and the picture of this girl is somewhere on the internets but I couldn't find it now. Clearly it has something to do with the midfacial bone structure but unfortunately I don't know any better.
EDIT: I found that picture. It wasn't as accentuated as I remembered. Page 330.
http://www.slideshare.net/kptaiping/aob-correct-by-le-fort-i-or-bsso (http://www.slideshare.net/kptaiping/aob-correct-by-le-fort-i-or-bsso)
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screwsandpllates, i think it's a combo of things.
do you have a negative under eye vector? That is, like the girl on p. 330 that Jaws posted you can see that the under eye area is not supported by a strong orbital rim or cheekbone. This can lead, even in young people, to mid-face ptosis: drooping fat pad. I think it also has to do with your tissue quality, some people's skin is more taut and elastic, other's thicker and prone to drooping. You have a few options none of which alone will necessarily fix it. 1) a midface lift, if you're a girl that's good because if they do a full face lift you don't have the sideburn behind the ear problem and facelift's by good surgeons are virtually undetectable when healed. 2) you may still need under eye support to fill that area in, so then either a cheekbone advancement (however you want to call that, modified lefort 3, ZSO whatever)
Of course the latter alone may suffice. Without pics it's tough to advise of course.
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Thanks, jaws, for that link. Lazlo, I can send you a photo privately if you'd like to give your opinion on it.
I don't have very prominent cheekbones or orbital rims. I'm sort of afraid to get a face lift for fear of it looking fake or limiting my future options, but if that's what I need then so be it. I would like to get whatever I needed done over the summer because I am so sick of surgery and I want to be done with it.
One last question: Should I bring it up with my jaw surgeon?
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Thanks, jaws, for that link. Lazlo, I can send you a photo privately if you'd like to give your opinion on it.
I don't have very prominent cheekbones or orbital rims. I'm sort of afraid to get a face lift for fear of it looking fake or limiting my future options, but if that's what I need then so be it. I would like to get whatever I needed done over the summer because I am so sick of surgery and I want to be done with it.
One last question: Should I bring it up with my jaw surgeon?
Don't get a face lift until you're at least 40. Most PS looks like crap.
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Yeah, I'm wary of facelifts.
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I had this problem but it went away after I got a genio. Ask for a genioplasty and get the surgeon to lower your chin a couple of mm. It will counter the impaction.
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That is a good suggestion, but I had a genio during my surgery :/ I'm not sure how to fix this sagging. It's become so awful that I don't even want to go out anymore. I can look ok in photos from certain angles, but in person, I look so old. If anyone else has encountered this problem, let me know.
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That is a good suggestion, but I had a genio during my surgery :/ I'm not sure how to fix this sagging. It's become so awful that I don't even want to go out anymore. I can look ok in photos from certain angles, but in person, I look so old. If anyone else has encountered this problem, let me know.
But did you have your chin lowered when the genio was performed? I had my upper jaw impacted which created sagging. Then when I had the genio I asked them to lower my chin. So my facial height is now probably about the same as it was before, and the sagging isn't really a problem now. I seriously think you should look into getting your chin lowered if you have this problem.
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I think my chin was minimally lowered. I already have a very long face unfortunately :(
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I think my chin was minimally lowered. I already have a very long face unfortunately :(
Maybe zygomatic osteotomy to pick up the slack?
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I've booked a consult for radiesse to the upper cheekbone :) I hope it works out.
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I've booked a consult for radiesse to the upper cheekbone :) I hope it works out.
Isn't that a permanent filler? If you want to try to fix it with filler, why not try a non-permanent one first?
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It is. It lasts about 2 years. My consult is coming up soon. I'm terrified. I start school soon, so I can't take time off for swelling :/ It's now or winter break. Saline seems like a good option, but I've heard that it isn't always an accurate representation due to the different viscosity. I guess it's better than nothing though?
Radiesse is apparently better for supporting soft tissue, as it is calcium hydroxyapatite which is injected right onto the bone. Juvederm is an HA (I know that you all know this lol -- i'm just writing this out to organize my own thoughts, being sleep deprived and whatnot), so it is temporary and reversible. The only problem with that is that it is soft and does not provide as much 'bony support' as Radiesse.
I paid 250 for the consult fee (that I will get back if I cancel at least 24 hours before the date).
My sister thinks I should lose about 20-30 lbs first (I weigh 125) and see if that decreases the malar fat pads. I actually do have nice cheekbones, as far as height and shape go, but they are just very small. What a nightmare it would be to pay for permanent injections, only to look worse :/
I feel bad for harping on about this, but these cheeks are really bugging me. I will gladly share photos via private message if you have any suggestions as to what might look good.
Anyway, this is the guy I'm thinking of going to for fillers: https://www.youtube.com/watch?v=o3jbKH-RIew
Has anyone been to him or heard about him?
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It's been a year and a half unfortunately :(
I agree with gaunt faces looking weird, but Idk what to do at this point.
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I think you should absolutely go for this procedure. I think you're pretty as is, but this might give you that perfect finish. It's great that it's done on the bone, lasts for a long time and actually there's nothing foreign to your own body. And this doc looks like he knows what he's doing. Let us know how it goes. This sounds amazing and I'd totally do it myself after jaw surgery to give that finishing edge.
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Thank you! I hope I don't come out looking like Jigsaw.
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Thank you! I hope I don't come out looking like Jigsaw.
Don't worry you'll be fine, and this too alas will dissipate. Though I have heard that people who have this done multiple times over the years end up with a permanent result. So it'll only be permanent if you end up liking it and repeat the procedure. I think you'll look great.
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Thanks! I'll let you know how it goes!
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Thanks! I'll let you know how it goes!
How did it go ?
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How did it go ?
Hey there. I'm back on this site after a long hiatus. I ended up getting filler in my upper cheek. It wasn't with Dr. Diamond, but some other surgeon (Dr. T). It made my eyes look youthful and bright because of the support it offered, but the dude is too hung up on lateral projection. It just doesn't suit come people (like those with long faces ... me). He did a nice job on the right side, but then when he got to the left side, he made an "oh s**t" face. I now see why. It looks... ok now. I had it done about 8 months ago. I want it to go away soon. I probably have another year and a half before it does. The sagging didn't go away. Don't let anyone ever tell you it's volume loss. It isn't. I should have had a facelift.
I'll possibly post photos if anyone would like to see.
I'm on the hunt for a good facelift surgeon (among other surgeons for other reasons). I wish I had just gotten one ASAP after my surgery (once it healed). I emailed my jaw surgeon and asked for his advice. Hopefully he gets back to me.
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If you have a bone deficiency a facelift may only make things worse.
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If you have a bone deficiency a facelift may only make things worse.
How so? I definitely have a weaker midface and orbital area, but i feel like with some re-suspension it could look nice.
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How so? I definitely have a weaker midface and orbital area, but i feel like with some re-suspension it could look nice.
How old are you?
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How old are you?
I'm 22
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I'm 22
Too young for facelifts.
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Maybe consider this:
http://www.ncbi.nlm.nih.gov/pubmed/25260139
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Maybe consider this:
http://www.ncbi.nlm.nih.gov/pubmed/25260139
I know that 22 is young, but I feel like my face aged more than normally due to having bone removed. I'm not sure about that filler compared to the ones I've had (thank you for the suggestion btw :)) but I did get fillers in an attempt to camouflage the sagging/bulging and it just made me look puffy and unnatural. The saggy area was still there, but my cheeks just looked bulgier to compensate.
I'm looking into facelifts with some doctors, but I'm worried they'll say the same thing. To be honest, I've never heard of anyone under the age of 30 getting a facelift so I'm not holding my breath.
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I know that 22 is young, but I feel like my face aged more than normally due to having bone removed. I'm not sure about that filler compared to the ones I've had (thank you for the suggestion btw :)) but I did get fillers in an attempt to camouflage the sagging/bulging and it just made me look puffy and unnatural. The saggy area was still there, but my cheeks just looked bulgier to compensate.
I'm looking into facelifts with some doctors, but I'm worried they'll say the same thing. To be honest, I've never heard of anyone under the age of 30 getting a facelift so I'm not holding my breath.
You had impaction? Upper midface deficiency is best solved with osteotomy. Implants look fake. If you can't afford, stomach a modified lf3, then a zygomatic osteotomy is the next best thing and they look pretty good on women.
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You had impaction? Upper midface deficiency is best solved with osteotomy. Implants look fake. If you can't afford, stomach a modified lf3, then a zygomatic osteotomy is the next best thing and they look pretty good on women.
Thank you for the suggestion! I will look into it :)
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You can have a mid face or mini life at any age.
Some models do it to get rid of nasolabial folds. However, I have no clue if it really lasts but a young face should support a good lift better than an old one.
Also there are strings and dissolvable threads to lift the cheek area. Never tried them but most doctors do not recommend them because they aren't working on everyone and can break (leaving you with one hanging cheek).
I know what you are talking about and had a similar problem after Jaw Surgery. For me filler helped. I realized that the temple and eye area can change severely and the eyes look more hollow and this IS NOT AGING, it's forward pulling from the movement of the jaw and maxilla. That's why too much projection will definitely look less feminine and shouldn't be performed on women!!!
I definitely need fat around my temples and around the eyes because I have asymmetrical hollows everywhere. Not sure what to do about the strange eye problem. The eyes somehow look pulled forward. You will have to balance out the hollows in the soft tissue that might have occurred. I believe that Fat Grafting (very carefully and with an extremely good doctor) and a mid face lift could help you. In LA there are many doctors who perform cheek lifts on younger patients but please do very good research before choosing one, so much can go wrong and PS is literally gambling after more and more doctors offer it.
Thanks for the reply! It's definitely tricky to navigate through all of the possible procedures and surgeons. Sorry to hear about your complications. How do you feel about your face now?
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Why do these doctors blame "volume loss" for everything.
The woman has too much volume in her mid face, which has dropped... hence the "hound" look.
No. You are confusing hard tissue and soft tissue. The "volume loss" of which the doctors speak is in reference to bone, which this woman could use. The volume of which you speak is skin, and I agree she has too much and/or it has lost much of its elasticity.
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I have the same problem — sagging cheeks. Am waiting to hear from my jaw surgeon. How did you ultimately fix this ?