jawsurgeryforums.com
General Category => Aesthetics => Topic started by: ppsk on November 10, 2016, 10:20:04 PM
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I've noticed that quite frequently the only thing talked about here regarding cheekbone augmentation is something like a ZSO, which as far as I can tell, is only going to move the cheekbones out on a lateral plane. Great if you need width, but if I'm correct in what I perceive, the "model" like eyes are achieved by greater support directly under the eye.
Widening the cheekbones will do very little to achieve this, rather the cheekbones need to come FORWARD and UP. You can test this on yourself by pushing the cheek fat up ever so slightly. You will immediately have more support under the eyes which creates this effect assuming you dont have other deficiencies:
(http://img0.ndsstatic.com/wallpapers/18e24bf6b4d6ecdd2761dff523430cee_large.jpeg)
Note that he doesn't have particularly WIDE cheekbones, his zygomatic arch isn't very prominent and yet he has great eyes due to forward support.
another example is leo dicaprio, who doesn't have notably wide cheekbones, but has great support under his eyes, giving him a striking appearance at an age where most men are starting to look like wax candles:
(https://img.rt.com/files/2016.02/original/56d34c31c361887b278b4606.jpg)
I don't believe most people looking for an aesthetic improvement lack width in the cheekbones (the rest of the skull would be necessarily lacking in width too I would presume for this to be the actual case), rather, they lack forward projection, much like weak chin projection can dramatically impact a face.
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totally right. sinn's surgery can do something for this, but possible scar is evident. and maybe implants plus soft tissue canthopasty. fat injections as well? I dunno, this is sort of the holy grail for us right now.
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@ Lazlo @ ilovethemoon @ppsk
So in summary there are five aspects to cheekbones that we have to consider.
1) - Lateral projection of the zygomatic body
2) - Lateral prominence of the zygomatic arch
3) - Vertical placement of the cheekbone
4) - Forward projection of the cheekbone
5) - Shape of the cheekbone
Are we saying that lateral projection of the actual zygomatic body is sort of irrelevant in terms of male aesthetics? If you want to see what a face looks like with only lateral projection of the zygomatic body itself, Mabye we can look at mongoloid skulls which tend to have wide zygo mass. I mean this is the chief effect of the ZSO and it hasn't really been shown to be effective for the results that we want to achieve. What do you guys think?
Obviously this post emphasises 3) and 4). I think I agree actually, that these are the most important factors. I think that the importance of these two elements is indisputable.
3) - Vertical placement of the cheekbone is essential, as you say, because of how it 'frames' the eye and gives that striking look that you describe with Leonardo Di Caprio. I feel like this aspect also involves projection of the lateral orbital rim. Mabye a big part of this aspect is contiguity between the lateral orbital rim and the prominence of the cheekbone itself? What do you guys think?
4) - About forward projection. I think this goes hand in hand with the vertical placement. Whilst 3) is the basis for good eye support, I think forward projection actually gives that eye support. Having high set cheekbones without forward projection is like having a million dollars in a frozen bank account. You've got the raw materials, but lack the ability to really see benefit. In that sense I think that it's the combination of high set and forward projected cheekbones that is really important.
What about the other factors? Part of me tells me that 2) - lateral zygomatic arch prominence is less important than is made out. But then I'm reminded of the 'male model look' which often features sharp and protruding zygomatic arches. I don't really know what to say about this? I mean taking my face as an example, I have noticeably less lateral projection of the zygomatic body and zygomatic arch on the left side of the face (so lacking 1) and 2)), and it really throws my oblique view off from the left side. It makes it look like it lacks depth, a feature which the right side of my face doesn't lack. I'm not sure whether this is a consequence of a lack of zygomatic body projection, zygomatic arch projection, or both.
Another thing to consider is whether this is a 'minimum threshold' type thing. What I mean by that is that mabye lateral prominence of the zygomatic body is a feature where, if you lack it, it gives an underdeveloped look, but if you have it, it doesn't really make you stand out in any way. Mabye it just makes you look 'normal'?
5) Shape of the cheekbone is a very complicated one. Are we looking for angularity? If we are, is it in the sense of having a rounded cheekbone v. an 'apexed' cheekbone (see below: *). Are we looking for a cheekbone that isn't vertically long? Does the rotation of the cheekbone have any role? If it does, what kind of rotation are we talking about?
Let's try and really engage with this puzzle here guys
* 'apexed' - what I mean by this is a cheekbone where the angle between the saggital plane of the cheekbone meets the horizontal plane of the cheekbone, is sharp rather than smoothed and rounded out. 'Saggital' is the direction from 'front to back' of the head, horizontal is 'side to side', vertical is 'top to bottom'.
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totally right. sinn's surgery can do something for this, but possible scar is evident. and maybe implants plus soft tissue canthopasty. fat injections as well? I dunno, this is sort of the holy grail for us right now.
A modified lefort 3 with a slight CCW rotation would do the job on a normal person I think.
I dont know many doctors who will perform the procedure for purely aesthetic reasons on someone who isnt deformed.
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@ Lazlo @ ilovethemoon @ppsk
So in summary there are five aspects to cheekbones that we have to consider.
1) - Lateral projection of the zygomatic body
2) - Lateral prominence of the zygomatic arch
3) - Vertical placement of the cheekbone
4) - Forward projection of the cheekbone
5) - Shape of the cheekbone
Are we saying that lateral projection of the actual zygomatic body is sort of irrelevant in terms of male aesthetics? If you want to see what a face looks like with only lateral projection of the zygomatic body itself, Mabye we can look at mongoloid skulls which tend to have wide zygo mass. I mean this is the chief effect of the ZSO and it hasn't really been shown to be effective for the results that we want to achieve. What do you guys think?
Obviously this post emphasises 3) and 4). I think I agree actually, that these are the most important factors. I think that the importance of these two elements is indisputable.
3) - Vertical placement of the cheekbone is essential, as you say, because of how it 'frames' the eye and gives that striking look that you describe with Leonardo Di Caprio. I feel like this aspect also involves projection of the lateral orbital rim. Mabye a big part of this aspect is contiguity between the lateral orbital rim and the prominence of the cheekbone itself? What do you guys think?
4) - About forward projection. I think this goes hand in hand with the vertical placement. Whilst 3) is the basis for good eye support, I think forward projection actually gives that eye support. Having high set cheekbones without forward projection is like having a million dollars in a frozen bank account. You've got the raw materials, but lack the ability to really see benefit. In that sense I think that it's the combination of high set and forward projected cheekbones that is really important.
What about the other factors? Part of me tells me that 2) - lateral zygomatic arch prominence is less important than is made out. But then I'm reminded of the 'male model look' which often features sharp and protruding zygomatic arches. I don't really know what to say about this? I mean taking my face as an example, I have noticeably less lateral projection of the zygomatic body and zygomatic arch on the left side of the face (so lacking 1) and 2)), and it really throws my oblique view off from the left side. It makes it look like it lacks depth, a feature which the right side of my face doesn't lack. I'm not sure whether this is a consequence of a lack of zygomatic body projection, zygomatic arch projection, or both.
Another thing to consider is whether this is a 'minimum threshold' type thing. What I mean by that is that mabye lateral prominence of the zygomatic body is a feature where, if you lack it, it gives an underdeveloped look, but if you have it, it doesn't really make you stand out in any way. Mabye it just makes you look 'normal'?
5) Shape of the cheekbone is a very complicated one. Are we looking for angularity? If we are, is it in the sense of having a rounded cheekbone v. an 'apexed' cheekbone (see below: *). Are we looking for a cheekbone that isn't vertically long? Does the rotation of the cheekbone have any role? If it does, what kind of rotation are we talking about?
Let's try and really engage with this puzzle here guys
* 'apexed' - what I mean by this is a cheekbone where the angle between the saggital plane of the cheekbone meets the horizontal plane of the cheekbone, is sharp rather than smoothed and rounded out. 'Saggital' is the direction from 'front to back' of the head, horizontal is 'side to side', vertical is 'top to bottom'.
I don't believe the lateral projection is super important no. Yes many models have strikingly wide cheekbones but so do many people in relatively primitive countries and often its not a good look. Theres some models with extremely wide cheekbones and they look alien, not attractive.
Also the thing to consider with a lot of models is the tricks of the trade A) lighting, which is super important. I saw someone commenting that Simon Nessman didnt look as impressive in his candid facebook photos as he did in professional shoots - well duh. B) makeup much like for actors, is applied to help these features stand out even more than they naturally do which helps frame the face under intense light.
what often separates good looking people from average looking people in the eye area is the forward projection of the cheekbones. Take for example, dan stevens, who actually has relatively weak jaw by hollywood standards, and yet is very good looking to women because of his eye area:
(http://cdn04.cdn.justjared.com/wp-content/uploads/2016/01/stevens-milanmfw/dan-stevens-russell-crowe-hit-milan-for-mens-fashion-week-14.jpg)
(https://s-media-cache-ak0.pinimg.com/originals/81/c5/c3/81c5c382e721dd71ac3c1913e81c72e8.jpg)
notice again, lateral prominence is not notable. What is notable is the support directly under the eye which creates the cushioning effect.
I don't think comparisons to mongoloid or primitive human skulls are germane. I've noticed in circles that discuss male aesthetics there is tendency to be obsessive about hyper-masculinity; bigger, thicker everything. But there are modern examples of this that aren't at all good looking. The great khali is undoubtedly masculine looking, very intimidating, huge bony prominence everywhere...... but hes f**k ugly.
If someone really feels like they lack prominence on the zygo, sure maybe the ZSO is the answer, but the before/afters of ZSO available on the internet are very telling I feel: most look barely different after and usually not much better. I've been at various levels of bodyfat in my life and usually the zygo arch becomes prominent at low levels of bodyfat.
one of the only decent results of eye area augmentation ive seen came from orbital rim implants. This seems to actually make a notable impact because it gives support directly under the eye while a ZSO as it is typically performed tends to take away support from what I understand. But i dont think implants are a stable solution especially in that area.
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I just thought of something. How do we know these Hollywood types we're referencing aren't using fillers to get their looks, especially in the cheek/eye junction area?
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For under eye area i recommend BIO OSS implants.
http://www.noormanvanderdussen.com/feminization/cheek-bone-correction.html
This doctor f.e. does everything and his preference is bio oss!
Preference:
The advantages of Bio-Oss: it is placed in a sub-periosteal pocket, through an intra-oral approach. This is our preference, because moulding is easy and the smooth edges at the border of the implant regions (zygomatic area, lateral orbital rim, lateral infra orbital rim area).
The maximum point of augmentation must be more lateral than infra-orbital in the direction of the arch, in order to avoid the 'miss-piggy' look.
What do you think about BIO OSS?
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I just thought of something. How do we know these Hollywood types we're referencing aren't using fillers to get their looks, especially in the cheek/eye junction area?
Because good looking people exist outside of cosmetic surgery and because most of them were good looking before derma filler was even a thing.
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For under eye area i recommend BIO OSS implants.
http://www.noormanvanderdussen.com/feminization/cheek-bone-correction.html
This doctor f.e. does everything and his preference is bio oss!
Preference:
The advantages of Bio-Oss: it is placed in a sub-periosteal pocket, through an intra-oral approach. This is our preference, because moulding is easy and the smooth edges at the border of the implant regions (zygomatic area, lateral orbital rim, lateral infra orbital rim area).
The maximum point of augmentation must be more lateral than infra-orbital in the direction of the arch, in order to avoid the 'miss-piggy' look.
What do you think about BIO OSS?
BIO OSS sounds like a more expensive version of HA paste. I dont know.
Might be worth meeting with that doctor, but its a bit worrying that his website seems exclusively geared towards female patients and female orientated procedures, and has no B/As at all.
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I don't believe the lateral projection is super important no. Yes many models have strikingly wide cheekbones but so do many people in relatively primitive countries and often its not a good look. Theres some models with extremely wide cheekbones and they look alien, not attractive.
Also the thing to consider with a lot of models is the tricks of the trade A) lighting, which is super important. I saw someone commenting that Simon Nessman didnt look as impressive in his candid facebook photos as he did in professional shoots - well duh. B) makeup much like for actors, is applied to help these features stand out even more than they naturally do which helps frame the face under intense light.
what often separates good looking people from average looking people in the eye area is the forward projection of the cheekbones. Take for example, dan stevens, who actually has relatively weak jaw by hollywood standards, and yet is very good looking to women because of his eye area:
(http://cdn04.cdn.justjared.com/wp-content/uploads/2016/01/stevens-milanmfw/dan-stevens-russell-crowe-hit-milan-for-mens-fashion-week-14.jpg)
(https://s-media-cache-ak0.pinimg.com/originals/81/c5/c3/81c5c382e721dd71ac3c1913e81c72e8.jpg)
notice again, lateral prominence is not notable. What is notable is the support directly under the eye which creates the cushioning effect.
I don't think comparisons to mongoloid or primitive human skulls are germane. I've noticed in circles that discuss male aesthetics there is tendency to be obsessive about hyper-masculinity; bigger, thicker everything. But there are modern examples of this that aren't at all good looking. The great khali is undoubtedly masculine looking, very intimidating, huge bony prominence everywhere...... but hes f**k ugly.
If someone really feels like they lack prominence on the zygo, sure maybe the ZSO is the answer, but the before/afters of ZSO available on the internet are very telling I feel: most look barely different after and usually not much better. I've been at various levels of bodyfat in my life and usually the zygo arch becomes prominent at low levels of bodyfat.
one of the only decent results of eye area augmentation ive seen came from orbital rim implants. This seems to actually make a notable impact because it gives support directly under the eye while a ZSO as it is typically performed tends to take away support from what I understand. But i dont think implants are a stable solution especially in that area.
On the second, younger picture; he appears to have a lot of lateral projection. But the lateral projection is of the zygomatic arch relative to the zygomatic body. The zygomatic body doesn't have as much lateral projection sure. Also you're assuming that lateral projection isn't that important because it isn't incredibly important from the front. On my own face I've noticed that lateral projection gives the face more depth from an oblique view. My other half with little lateral projection, looks very flat and underdeveloped in comparison.
Nobody here claimed that hyper masculinity is attractive, or that 'big everything' is desirable at all. I do feel like lateral projection has some role to play however, but only up to a point. As I said in my previous post: it might be a feature which should reach a minimum threshold to avoid appearing underdeveloped, rather than a feature that appears striking or desirable in large quantities.
However, I completely agree that the most important part is cheekbone forward projection in the area directly below the eye. So high set and forward projected cheekbones with a prominent zygomatic arch is what we should be aiming for, with some degree of lateral projection of the zygomatic body if that area is lacking.
To illustrate what the lateral projection of the zygomatic arch and lateral projection of the zygomatic body, view the pictures attached showing three configurations: starring Simon Nessman, David Gandy and Tyson Ballou. Nessman appears to have a lot of lateral and forward projection of the zygomatic body, but not of the zygomatic arches. This makes his cheek area appear flatter on the sides, from the front, which isn't the best look imo. Tyson Ballou appears to have flared zygomatic arches with little lateral projection of the zygomatic body. Imo this looks better than Nessman's configuration. David Gandy, however, has both: great lateral and forward projection of the zygomatic body, with flared zygomatic arches that project further than the malar body itself. This is the best look in my opinion.
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[attachment deleted by admin]
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On the second, younger picture; he appears to have a lot of lateral projection. But the lateral projection is of the zygomatic arch relative to the zygomatic body. The zygomatic body doesn't have as much lateral projection sure. Also you're assuming that lateral projection isn't that important because it isn't incredibly important from the front. On my own face I've noticed that lateral projection gives the face more depth from an oblique view. My other half with little lateral projection, looks very flat and underdeveloped in comparison.
Nobody here claimed that hyper masculinity is attractive, or that 'big everything' is desirable at all. I do feel like lateral projection has some role to play however, but only up to a point. As I said in my previous post: it might be a feature which should reach a minimum threshold to avoid appearing underdeveloped, rather than a feature that appears striking or desirable in large quantities.
However, I completely agree that the most important part is cheekbone forward projection in the area directly below the eye. So high set and forward projected cheekbones with a prominent zygomatic arch is what we should be aiming for, with some degree of lateral projection of the zygomatic body if that area is lacking.
To illustrate what the lateral projection of the zygomatic arch and lateral projection of the zygomatic body, view the pictures attached showing three configurations: starring Simon Nessman, David Gandy and Tyson Ballou. Nessman appears to have a lot of lateral and forward projection of the zygomatic body, but not of the zygomatic arches. This makes his cheek area appear flatter on the sides, from the front, which isn't the best look imo. Tyson Ballou appears to have flared zygomatic arches with little lateral projection of the zygomatic body. Imo this looks better than Nessman's configuration. David Gandy, however, has both: great lateral and forward projection of the zygomatic body, with flared zygomatic arches that project further than the malar body itself. This is the best look in my opinion.
Its worth noting the second younger picture is him at lower bodyfat and on a movie set with controlled lighting and makeup.
Its not that i dont think lateral projection has any role, i just think it is overstated, especially the zygomatic arch which is not prominent on 99% of men who are not already very lean. I consider it the equivalent of too much focus on having a square angular jaw - there are numerous men who don't have this angularity that are often considered better looking than the ones that do (Mel gibson for example, is pretty much all chin). So in that example, its not that having an angular jaw wouldnt be nice, i just dont think its worth focusing on before you fix the major issues first you see what i mean?
So we have the ZSO to consider obviously, but the results arent very impressive, i would perhaps even go as far as saying completely pointless in many of the B/As, and it also seems to carry the secondary problem of giving a flat effect to the cheeks. If what I'm thinking is correct however.... it might be necessary to get a ZSO first BEFORE you can actually look at moving the cheekbones forward.
What else is there? Lefort 3? Modified lefort 3 there is at least one case of a member having this on these forums, yet no before/after, precious few details which honestly is a big problem with surgery patients, its all very wham bam thank you mam, leave and leave the rest of us to figure it out.
Maxilla advancements..... seem to provide mixed results. It definitely seems to give more forward projection to the cheeks which is great, but only forward, not forward and UP. In cases its not a good result at all.
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Its worth noting the second younger picture is him at lower bodyfat and on a movie set with controlled lighting and makeup.
Its not that i dont think lateral projection has any role, i just think it is overstated, especially the zygomatic arch which is not prominent on 99% of men who are not already very lean. I consider it the equivalent of too much focus on having a square angular jaw - there are numerous men who don't have this angularity that are often considered better looking than the ones that do (Mel gibson for example, is pretty much all chin). So in that example, its not that having an angular jaw wouldnt be nice, i just dont think its worth focusing on before you fix the major issues first you see what i mean?
So we have the ZSO to consider obviously, but the results arent very impressive, i would perhaps even go as far as saying completely pointless in many of the B/As, and it also seems to carry the secondary problem of giving a flat effect to the cheeks. If what I'm thinking is correct however.... it might be necessary to get a ZSO first BEFORE you can actually look at moving the cheekbones forward.
What else is there? Lefort 3? Modified lefort 3 there is at least one case of a member having this on these forums, yet no before/after, precious few details which honestly is a big problem with surgery patients, its all very wham bam thank you mam, leave and leave the rest of us to figure it out.
Maxilla advancements..... seem to provide mixed results. It definitely seems to give more forward projection to the cheeks which is great, but only forward, not forward and UP. In cases its not a good result at all.
I do see what you mean and I sort of agree with the comparison between zygomatic arch prominence and the angular jaw. They're not essentially to be good looking, but that doesn't mean to say that giving an average looking person those features won't improve them. In the eyes of ordinary people, the presence of those features will definitely make that particular individual better looking than he would otherwise be. I would argue that the comparison between the David Gandy picture and the Simon Nessman picture demonstrates how the presence of the zygomatic arch adds another dimension to the male face, giving it a winged look. Similarly the comparison between Tyson ballou's and David Gandy's picture demonstrates how lateral projection has a role in giving the face more depth.
However it's obvious that vertical placement and forward projection of the cheekbones are both more important: those 3 are supermodels and they all share it. Unfortunately there's simply no way to achieve the 'high set' configuration with osteotomies. This is why I am getting a custom midface implant next year which will give me: higher set cheekbones, lateral cheek projection, zygomatic arch protrusion, cheek forward projection, lateral orbital rim projection, infraorbital projection, and paranasal projection all at once. I know this is anathemical to the basis of this forum and the philosophies that float around here, but in my opinion it's really the only solution.
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For under eye area i recommend BIO OSS implants.
http://www.noormanvanderdussen.com/feminization/cheek-bone-correction.html
This doctor f.e. does everything and his preference is bio oss!
Preference:
The advantages of Bio-Oss: it is placed in a sub-periosteal pocket, through an intra-oral approach. This is our preference, because moulding is easy and the smooth edges at the border of the implant regions (zygomatic area, lateral orbital rim, lateral infra orbital rim area).
The maximum point of augmentation must be more lateral than infra-orbital in the direction of the arch, in order to avoid the 'miss-piggy' look.
What do you think about BIO OSS?
I like the idea of this a lot and I like the sound of this doctor. Is bio oss good stuff? I still don't know what it is exactly? What's it made of? Does it induce and erosion? There are mixed theories about HA paste whether its' good or not. I'd get it in ADDITION to an osteotomy. Like if I had a modified lefort 3 with Sinn I wish he'd augment the area further with BIO OSS. But it's good that's this doctor's preference so he must know how to use it.
Yes no before and afters is troubling, however I like that he has experience in facial feminization. Since the cheekbone thing is often a somewhat female thing as well --like melania trump who has the same cheekbones that make both male and female models hot. So it's a plus in my book, also indicates he's well versed in aesthetics.
Just wish there was more of a one-stop for all. But hey.....
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Do you expect that to change your eye area shape as a knock-on effect?
Do you think that custom midface implant will give a superior effect to a modified lefort 3?
Finally what do you make of Eppley's "extended cheekbone implants"?: http://exploreplasticsurgery.com/extended-cheek-implants-high-cheekbone-look/
I think he has the right idea about shape, but i don't want implants.
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The second guy has visible mid face asymmetry - deviated septum, right side of upper lip higher than left, scleral show in the right eye (not squinting hard enough. You have to realise that every single model and celebrity squints like mad)... His hairline is uneven. Yet he is a model. It's the big picture that counts.
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The second guy has visible mid face asymmetry - deviated septum, right side of upper lip higher than left, scleral show in the right eye (not squinting hard enough. You have to realise that every single model and celebrity squints like mad)... His hairline is uneven. Yet he is a model. It's the big picture that counts.
What is the relevance of this to my post, or indeed to the entire thread?
He's a model because of his features. His well developed maxilla combined with high set zygos with prominent zygomatic arches. A tall midface with a perfect nose:upper lip ratio, and perfect mandibular shape and projection. Excellently projected supraorbital rims. Piercing eyebrows which compliment the low-trust downward swung mouth and pull attention away from the mediocre eye shape. And of course, optimal bodyfat with smooth, healthy, youthful skin.
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He's a model because everything on his face flows together. There are people with great features yet they are not attractive. If he had worse features he still would've looked good. This is what happens when they age (Paul Newman) - lips thin, eyes droop, yet they still look good.
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However it's obvious that vertical placement and forward projection of the cheekbones are both more important: those 3 are supermodels and they all share it. Unfortunately there's simply no way to achieve the 'high set' configuration with osteotomies. This is why I am getting a custom midface implant next year which will give me: higher set cheekbones, lateral cheek projection, zygomatic arch protrusion, cheek forward projection, lateral orbital rim projection, infraorbital projection, and paranasal projection all at once. I know this is anathemical to the basis of this forum and the philosophies that float around here, but in my opinion it's really the only solution.
I am thinking much the same as you here, however I suspect that an osteotomy COULD be done to achieve this, its just not done for whatever reason. I'm not anti-implants like most of this forum, i just believe the area would be particularly prone to migration as i doubt they will use titanium screws in that area (i could very well be wrong), and i dont trust the notion that a scar capsule is enough to stop the movement of an implant especially if you were to take a blow/impact to the face. Perhaps they are the only way to go but preferably id like to exhaust all other options first, and iirc - for whatever reason - osteotomies end up being considerably cheaper than custom implants.
I cannot imagine a doctor who would be willing to do an incredibly invasive procedure like a LF3 would not be willing to work outside the box on a cheekbone osteotomy
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He's a model because everything on his face flows together. There are people with great features yet they are not attractive. If he had worse features he still would've looked good. This is what happens when they age (Paul Newman) - lips thin, eyes droop, yet they still look good.
His face flows together because.... oh yeah, the particular combination of features he has. Our job is to find out what that combination is, and why it produces the result it does. Not resign ourselves to 'it's just the way his face flows'.
An optimally projecting maxilla, with optimal zygomatic structure, with optimal orbital rims, elongated palpebral fissures with great interpupillary distance, with great skin, a well proportioned midface, with great mandibular shape and structure, with no excessive prominences or asymmetries (I.e. No overly big lips, nose, eyes, etc.), with optimal bodyfat will always be good looking.
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I am thinking much the same as you here, however I suspect that an osteotomy COULD be done to achieve this, its just not done for whatever reason. I'm not anti-implants like most of this forum, i just believe the area would be particularly prone to migration as i doubt they will use titanium screws in that area (i could very well be wrong), and i dont trust the notion that a scar capsule is enough to stop the movement of an implant especially if you were to take a blow/impact to the face. Perhaps they are the only way to go but preferably id like to exhaust all other options first, and iirc - for whatever reason - osteotomies end up being considerably cheaper than custom implants.
I cannot imagine a doctor who would be willing to do an incredibly invasive procedure like a LF3 would not be willing to work outside the box on a cheekbone osteotomy
The point is an osteotomy cannot create new shape where it never existed. I feel like the LF3 is a very straight forward procedure compared to what you want to do with the zygos. Moving the zygomatic body upwards means replacing the bone that is already there (in the location where you want the zygomatic prominence to sit).
Screws are used in this particular implant. Also the cost is very very low for the amount that the implant can do. It's $12-13k and it covers the entire midfacial region from the infra orbital rim down to the paranasal region, and across to the zygomatic body all the way over to the zygomatic arches and up towards the lateral orbital rim.
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Silicone is garbage. Do not get it. It feels fake inside your face and will come lose when your orbital sockets shrinks with age. The only type of implant worth to consider is CT bone and it's not even available.
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Silicone is garbage. Do not get it. It feels fake inside your face and will come lose when your orbital sockets shrinks with age. The only type of implant worth to consider is CT bone and it's not even available.
CT bone hype is retarded it has ZERO history and no clinical studies backing its efficacy.
Its all marketing at this point and thats it. The fact the company is having this much trouble, does not bode well. And at the end of the day, it is still an implant and carries all the usual problems.
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The point is an osteotomy cannot create new shape where it never existed. I feel like the LF3 is a very straight forward procedure compared to what you want to do with the zygos. Moving the zygomatic body upwards means replacing the bone that is already there (in the location where you want the zygomatic prominence to sit).
Screws are used in this particular implant. Also the cost is very very low for the amount that the implant can do. It's $12-13k and it covers the entire midfacial region from the infra orbital rim down to the paranasal region, and across to the zygomatic body all the way over to the zygomatic arches and up towards the lateral orbital rim.
who are you getting to do this implant if you dont mind me asking?
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I like the idea of this a lot and I like the sound of this doctor. Is bio oss good stuff? I still don't know what it is exactly? What's it made of? Does it induce and erosion?
Bio Oss is similar to HA. It is clinically tested and safe. I did a lot of research. I think Bio Oss is the best bone substitute material for the moment.
It does not cause bone erosion and is permanent. I have spoken with 2 world famous max fac and cranio surgeons who confirmed me that. In Zurich there are some good surgeons who use it, Triaca f.e. uses it sometimes for orbital rim augmentation.
For more information please see the link below.
http://www.geistlich-na.com/en-us/professionals/bone-substitutes/bio-oss/user-benefits/
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Now let me tell you he showed me one patient —not Earl, but someone more recent who had the “modified lefort-3” yes there was a difference but it just resembled a weak ZSO to me. In fact, when I studied the before and after profiles there was no significant augmentation to the area directly beneath the eye and this was not as augmented as when I see Dr. Yaremchuck’s examples of orbital rim implants with “canthopexy” no Sir, not even close. Honestly from the example of the modified lefort 3 I saw this procedure is not the holy grail to your looks as many of you have been assuming I’m very sorry to report and I don’t think it can do a lot at all. You’re like to get a much more dramatic result from a genioplasty to your appearance. The problem I think rests in the facts that the movement isn’t that much AND you’re limited by your own anatomy. If you don’t have large bones they’re not gonna show very well.
Lazlo is absolutely right! A mod. Lefort III does not improve your eye area since the eye supporting part of the bone is not touched.
Unfortunately there are no very effective zygo/cheekbone surgeries. The difference in the amount of bone mass in a male model's zygos vs an average guy is just enormous and can't be bridged with modern surgery.
But I do not think that Zygo surgery is s**t.
So what are your options???
I did a lot of research. I do not like implants (medpor/silicon). I prefer osteotomies because they are more natural. But the problem with most of osteotomies is that it is very difficult to find an appropriate surgeon who is willing to do this for you if you are not malformed. And imo a mod. Lefort III is insane.
At the end i think the best option is a Zso AND BIO OSS IN ADDITION. It is described as a safe and fast surgery. A Zso gives you lateral and also a little bit forward projection.
OR PLEASE TELL ME WHAT DO YOU GUYS THINK IS THE BEST OPTION? There are drawbacks to everything it seems.
Another thing: Some feminine features on men aren't necessarily bad. In fact they can be very alluring. And there is literally no difference between "masculine" and "feminine" cheekbones. Cheekbones are cheekbones.
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Lazlo is absolutely right! A mod. Lefort III does not improve your eye area since the eye supporting part of the bone is not touched.
Unfortunately there are no very effective zygo/cheekbone surgeries. The difference in the amount of bone mass in a male model's zygos vs an average guy is just enormous and can't be bridged with modern surgery.
But I do not think that Zygo surgery is s**t.
So what are your options???
I did a lot of research. I do not like implants (medpor/silicon). I prefer osteotomies because they are more natural. But the problem with most of osteotomies is that it is very difficult to find an appropriate surgeon who is willing to do this for you if you are not malformed. And imo a mod. Lefort III is insane.
At the end i think the best option is a Zso AND BIO OSS IN ADDITION. It is described as a safe and fast surgery. A Zso gives you lateral and also a little bit forward projection.
OR PLEASE TELL ME WHAT DO YOU GUYS THINK IS THE BEST OPTION? There are drawbacks to everything it seems.
Another thing: Some feminine features on men aren't necessarily bad. In fact they can be very alluring. And there is literally no difference between "masculine" and "feminine" cheekbones. Cheekbones are cheekbones.
Agreed. Feminine features on men are extremely attractive in some cases. Most really good looking male models are somewhat androgynous in their features.
Regardless, ZSO or modified lefort 3, and BIO-OSS (though I don't know what it is yet? will it turn to bone? does it vascularize? does it cause erosion?), and then some judiciously injected fat and/or filler.
That's the triple threat. Oh and an expert surgeon who understands the aesthetics of this. A lot of max facs don't know s**t about aesthetics.
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BIO-OSS is also no good. Zarrinbal told me it's the same garbage as HA paste and did not recommend getting it. Apparently he have been helping numerous of patients with serious tissue/bone inflammation created by HA paste. He told me stories of bone being all mushy/ structurally compromised. Some were implant cases too. Real horror.
Again, as of right now, there is nothing which can create high-set, masculine projecting cheekbones without risking your health long term. Silicone, medpor, HA paste, BIO-OSS it's all just not safe/satisfying enough. If CT bone don't turn out good, we need to wait for real 3d printed bone material implants using stem cells. That's about 5 to 10 years away.
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who are you getting to do this implant if you dont mind me asking?
Dr. Eppley, he's done it before successfully. I've seen results of what he can do with the orbital rim and paranasal area and it's very impressive. I'm yet to truly see results for the zygos but he claims that he's done custom implants for the zygo arches numerous times, and he's done lateral orbital rim stuff before too. Stepping into uncharted territory is a risk sure, but with an experienced surgeon and meticulous designing of the implant - here's hoping that risk can be minimised.
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Again, as of right now, there is nothing which can create high-set, masculine projecting cheekbones without risking your health long term. Silicone, medpor, HA paste, BIO-OSS it's all just not safe/satisfying enough. If CT bone don't turn out good, we need to wait for real 3d printed bone material implants using stem cells. That's about 5 to 10 years away.
Listen here. It's indisputable that there is no way to achieve all the elements of perfect zygomatic projection and set without custom made implants. No way at all. Silicone isn't ideal, sure. But it's either that or nothing at all. If we're serious about this stuff, there are certain compromises that have to be made. I for one am willing to accept the drawbacks of silicone in order to get the aesthetic result that I know to be achievable.
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BIO-OSS is also no good. Zarrinbal told me it's the same garbage as HA paste and did not recommend getting it. Apparently he have been helping numerous of patients with serious tissue/bone inflammation created by HA paste. He told me stories of bone being all mushy/ structurally compromised. Some were implant cases too. Real horror.
That is all nonsense and bulls**t!!!
The stories of it leading to tissue/bone inflammation / erosion etc. are anecdotal not laboratory results. HA f.e. has the same structure as natural bone so blood and tissue will grow into it.
http://www.arnettgunson.com/files/2015/02/hydroxyapatite.pdf
EDIT: I have informed the moderators and administrators!
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Something ive just considered...
It might be useful to see if you can find a skull scan of an attractive person vs an average person. I have no idea where to start looking for that, but I believe being able to see the differences in 3d or even an xray would be instrumental in then being able to determine what part of the structure you really need enhanced and how.
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Something ive just considered...
It might be useful to see if you can find a skull scan of an attractive person vs an average person. I have no idea where to start looking for that, but I believe being able to see the differences in 3d or even an xray would be instrumental in then being able to determine what part of the structure you really need enhanced and how.
Given unlimited funds, the best way to do it would be to pay a male supermodel to get the ct scan done. And then use it to compare to our own scans.
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That is all nonsense and bulls**t!!!
The stories of it leading to tissue/bone inflammation / erosion etc. are anecdotal not laboratory results. HA f.e. has the same structure as natural bone so blood and tissue will grow into it.
http://www.arnettgunson.com/files/2015/02/hydroxyapatite.pdf
EDIT: I have informed the moderators and administrators!
To my knowledge, there are different types of HA and some can cause problems, so that could be the cause of confusion.
The type of HA and method of processing it that A/G use is considered superior, to my understanding.
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yeah i'd really iike to see more skulls and also do comparative stuff with my skull model versus a male models.
I wonder if any good looking famous people's skulls are available like marlon brando or elvis presley.
wouldn't that be the best way to plan surgery if you had bio-oss or osteotomy. like skull now, and then what needs to be augmented to make it male model skull. PERFECT>
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yeah i'd really iike to see more skulls and also do comparative stuff with my skull model versus a male models.
I wonder if any good looking famous people's skulls are available like marlon brando or elvis presley.
wouldn't that be the best way to plan surgery if you had bio-oss or osteotomy. like skull now, and then what needs to be augmented to make it male model skull. PERFECT>
The thing is we more or less know what makes somebody good looking in general. There are certain areas of confusion: such as how much does maxillary projection really matter, how much does lateral orbital projection matter, and whether there is any role for the 'forward set' orbital box theory. But the point is, we know that maxillary and lateral orbital development is good to whichever degree, it's just a question of quantifying its importance and ideal configurations.
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We need to crowd fund the CT scan of a male model tier skull.
I'm up for this. I could try and get one my MM tier (too short to be an actual male model) friends to do it - we'll need to cover the cost of the CT scan and £200 or so for him so about £500 in total I'm guessing.
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i'd also be in, but he'd have to have excelent bone structure (not just goodlooking from a great eye area and just average bones), would need to see pics of his face to decide if i will continue to invest in it.
Yeah sure. I'll have to PM privately though
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I'm interested.
Has anyone like Eppley ever confirmed that having a CT scan of the desired look would be beneficial?
I have a feeling it's not as simple as we think just comparing the difference between skulls and making implants to fill in what's missing. A key thing being the skull widths and heights. I would conjecture the optimal approach would be to use a CT scan of a MM who has the same skull dimensions and that is going to be hard to do.
Its not that its as simple as going ohh hes got 2mm more of bone in this direction and that direction, custom implant, voila! Because of course you still have significant differences in soft tissues like the insertions and dimensions of muscles, fat storage etc.
But, none the less, it would be instrumental in getting a clearer idea of just how different the skull of a good looking person is to an average looking person, and in what areas in particular. It seems to me that a lot of bad plastic surgery results (the freakshow cases) are a result of trying to recreate a look without understanding what actually produces the look. The "hollow cheeks" for example has little to do with the fat pad in the cheek, and a whole lot more to do with a draped curtain effect being created by having wide cheekbones and a wide mandible.
So not optimal, no, but what is really. Instrumental however? definitely.
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Would it be any easier to obtain at what point different skull measurement ratios can essentially be considered 'ugly'?
Like if it's hard to say what exact skull measurements are ideal for any individual, given a MM skull reference, maybe it's helpful to also work from the bottom up, so to speak?
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It's all about proportions, not absolute measurements.
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update: i had been basing my misgivings about the ZSO on what seems to be a case of forum chinese whispers
there is B/A that was circulated here that was claimed to have been the result of a ZSO, it wasnt very good. However, apparently it was NOT a ZSO and the b/a was a man who had malar implants and a rhinoplasty.
here are what actual ZSO results can look like: http://www.academia.edu/6713021/1995_The_sandwich_zygomatic_osteotomy_-_technique_indications_and_clinical_results._JCMFS
pay close attention to figure 7. IMO that is a fantastic result.
(http://imgur.com/a/InRxd)
It has widened his cheekbone to the extent that he now has slight cheek hollows (which would probably be further defined by anything that widens the mandible) but he also seems to have more support under the eye, creating the cushioning effect!
No orthognathic surgery was performed in this case. The patient desired refinement of the nasal tip, definition of the cheekbones and mandibular angle, and volume reduction of the lower lip. (A) preoperative lateral view; (B) preoperative 3/4 profile view; (C) 18 month postoperative lateral view; (D) 18 month postoperative 3/4 profile view
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update: i had been basing my misgivings about the ZSO on what seems to be a case of forum chinese whispers
there is B/A that was circulated here that was claimed to have been the result of a ZSO, it wasnt very good. However, apparently it was NOT a ZSO and the b/a was a man who had malar implants and a rhinoplasty.
here are what actual ZSO results can look like: http://www.academia.edu/6713021/1995_The_sandwich_zygomatic_osteotomy_-_technique_indications_and_clinical_results._JCMFS
pay close attention to figure 7. IMO that is a fantastic result.
(http://imgur.com/a/InRxd)
It has widened his cheekbone to the extent that he now has slight cheek hollows (which would probably be further defined by anything that widens the mandible) but he also seems to have more support under the eye, creating the cushioning effect!
No orthognathic surgery was performed in this case. The patient desired refinement of the nasal tip, definition of the cheekbones and mandibular angle, and volume reduction of the lower lip. (A) preoperative lateral view; (B) preoperative 3/4 profile view; (C) 18 month postoperative lateral view; (D) 18 month postoperative 3/4 profile view
There's no denying that it's a great result, but it doesn't look as if vertical movement was performed. Ideally the cheekbone prominence would be higher and the zygomatic arches more flared. Great change overall though. I'm still inclined towards the custom implants however, due to the fact that my zygos are low set and my lateral orbital rims are underdeveloped.
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I wonder if the modified lefort iii brings out the zygomatic arches laterally?
I'm not sure - are you totally against custom implants for that area?
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update: i had been basing my misgivings about the ZSO on what seems to be a case of forum chinese whispers
there is B/A that was circulated here that was claimed to have been the result of a ZSO, it wasnt very good. However, apparently it was NOT a ZSO and the b/a was a man who had malar implants and a rhinoplasty.
here are what actual ZSO results can look like: http://www.academia.edu/6713021/1995_The_sandwich_zygomatic_osteotomy_-_technique_indications_and_clinical_results._JCMFS
pay close attention to figure 7. IMO that is a fantastic result.
(http://imgur.com/a/InRxd)
It has widened his cheekbone to the extent that he now has slight cheek hollows (which would probably be further defined by anything that widens the mandible) but he also seems to have more support under the eye, creating the cushioning effect
How do you come to this conclusion? If the mandible is increased in width shouldn't the lateral projection of the cheekbones reduce and thus the shadow become even smaller (or the chances in having one eliminated?)
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There's no denying that it's a great result, but it doesn't look as if vertical movement was performed. Ideally the cheekbone prominence would be higher and the zygomatic arches more flared. Great change overall though. I'm still inclined towards the custom implants however, due to the fact that my zygos are low set and my lateral orbital rims are underdeveloped.
I should say that i dont know if vertical movement is necessary. I was basing my concept of ZSO results off a picture that ive now found out was not a zso at all.
looking at this result, it seems obvious that he has the effect we are talking about..... perhaps you were right all along and its lateral projection that is very important. Maybe there is slightly vertical movement when performing the ZSO? I am not sure.
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update: i had been basing my misgivings about the ZSO on what seems to be a case of forum chinese whispers
there is B/A that was circulated here that was claimed to have been the result of a ZSO, it wasnt very good. However, apparently it was NOT a ZSO and the b/a was a man who had malar implants and a rhinoplasty.
here are what actual ZSO results can look like: http://www.academia.edu/6713021/1995_The_sandwich_zygomatic_osteotomy_-_technique_indications_and_clinical_results._JCMFS
pay close attention to figure 7. IMO that is a fantastic result.
(http://imgur.com/a/InRxd)
It has widened his cheekbone to the extent that he now has slight cheek hollows (which would probably be further defined by anything that widens the mandible) but he also seems to have more support under the eye, creating the cushioning effect!
No orthognathic surgery was performed in this case. The patient desired refinement of the nasal tip, definition of the cheekbones and mandibular angle, and volume reduction of the lower lip. (A) preoperative lateral view; (B) preoperative 3/4 profile view; (C) 18 month postoperative lateral view; (D) 18 month postoperative 3/4 profile view
Mommaerts old paper. I can't be bothered to find it but there is an older thread on here which details why he is a questionable choice at best. With that said the ZSO has value -if you lack forward and lateral projection. I've seen the user Stupidjaws results and they were exellent, just as good as the pictures from your link.
If you do not lack forward or lateral projection however you will be underhelmed or even displeased with the results. It is not much bone that is mobilized and the cheekbone will not be "raised". The improvement in the under-eye area is due to soft tissue being supported from below, if you already have support in this area it will not do much at all. Also beware of nasolabials which might appear if you advance your cheeks further than the rest of your midface.
For higher cheekbones, which is a masculine trait, as well as a more prominent ridge I am interested in deep long-term fillers. Implants in this area I object to empirically as I've yet to see even one good result for men.
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Mommaerts old paper. I can't be bothered to find it but there is an older thread on here which details why he is a questionable choice at best. With that said the ZSO has value -if you lack forward and lateral projection. I've seen the user Stupidjaws results and they were exellent, just as good as the pictures from your link.
If you do not lack forward or lateral projection however you will be underhelmed or even displeased with the results. It is not much bone that is mobilized and the cheekbone will not be "raised". The improvement in the under-eye area is due to soft tissue being supported from below, if you already have support in this area it will not do much at all. Also beware of nasolabials which might appear if you advance your cheeks further than the rest of your midface.
For higher cheekbones, which is a masculine trait, as well as a more prominent ridge I am interested in deep long-term fillers. Implants in this area I object to empirically as I've yet to see even one good result for men.
I am pretty confident i could get the exact same results as the guy in that paper.
The only thing i could find about mommaerts on here that is worrisome is a surgical horror story. Well, i hate to break it to people, but this is a risk with every single surgeon in the world. They all have horror story patients, probably a mix of poor bastards who genuinely got f**ked over by statistical anomaly, BDD nutjobs and malicious shills (anyone who has investigated eppley and yaremchuk for example, knows of the huge amount of shills both have attacking eachother)
that said, Zarrinbal is very well spoken of here, so if i were to get it i would probably get it with him since i want a chin wing anyway. Does anyone know if a ZSO and chin wing can be performed in the same operation? I can't see why not.
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I am pretty confident i could get the exact same results as the guy in that paper.
The only thing i could find about mommaerts on here that is worrisome is a surgical horror story. Well, i hate to break it to people, but this is a risk with every single surgeon in the world. They all have horror story patients, probably a mix of poor bastards who genuinely got f**ked over by statistical anomaly, BDD nutjobs and malicious shills (anyone who has investigated eppley and yaremchuk for example, knows of the huge amount of shills both have attacking eachother)
that said, Zarrinbal is very well spoken of here, so if i were to get it i would probably get it with him since i want a chin wing anyway. Does anyone know if a ZSO and chin wing can be performed in the same operation? I can't see why not.
You didn't search hard enough. MM is a butcher.
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Implants in this area I object to empirically as I've yet to see even one good result for men.
How many custom implant results have you seen exactly? Without that information, and information regarding their placement and the patients' bodyfat levels if you have seen any, you are not qualified to come to that conclusion. If you have seen results of high placed custom zygomatic implants in men with low bodyfat levels, I take that all back and I'm interested to hear more.
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I am pretty confident i could get the exact same results as the guy in that paper.
The only thing i could find about mommaerts on here that is worrisome is a surgical horror story. Well, i hate to break it to people, but this is a risk with every single surgeon in the world. They all have horror story patients, probably a mix of poor bastards who genuinely got f**ked over by statistical anomaly, BDD nutjobs and malicious shills (anyone who has investigated eppley and yaremchuk for example, knows of the huge amount of shills both have attacking eachother)
that said, Zarrinbal is very well spoken of here, so if i were to get it i would probably get it with him since i want a chin wing anyway. Does anyone know if a ZSO and chin wing can be performed in the same operation? I can't see why not.
Vertical placement is very very important. That particular patient's cheekbones were decently set. But even he would have benefited from higher cheekbones, just in visualising it. I guess if you are opposed to implants and you have high set zygos as is - a ZSO might be the answer. But in my opinion, if you're going to spend money and time on this, I wouldn't settle for a sub-optimal result when there are other alternatives that can raise the position of the cheekbone and augment the (important btw) zygomatic arches.
And yes a chin wing and a ZSO can be done at the same time - I know somebody (virtually) who had both done simultaneously with Zarrinbal. Make sure that you maxillo-mandibular projection and set is optimised as far as is practical first though (i.e. get bimax if you could benefit from it).
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Vertical placement is very very important. That particular patient's cheekbones were decently set. But even he would have benefited from higher cheekbones, just in visualising it. I guess if you are opposed to implants and you have high set zygos as is - a ZSO might be the answer. But in my opinion, if you're going to spend money and time on this, I wouldn't settle for a sub-optimal result when there are other alternatives that can raise the position of the cheekbone and augment the (important btw) zygomatic arches.
And yes a chin wing and a ZSO can be done at the same time - I know somebody (virtually) who had both done simultaneously with Zarrinbal. Make sure that you maxillo-mandibular projection and set is optimised as far as is practical first though (i.e. get bimax if you could benefit from it).
well thats what this thread is for buddy! What are those other options?
ZSO is the only one i know of. I saw ZSSO spoken of here once, but very little details.
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Could the vertical placement issue be addressed through some sort of HA augmentation when then bone is mobilized?
I've heard lots of docs talk about augmenting orbital rims and malar prominence with HA. Gunson and Arnett slather that s**t on like its nobodies business.
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well thats what this thread is for buddy! What are those other options?
ZSO is the only one i know of. I saw ZSSO spoken of here once, but very little details.
I don't think that there are any aside from implants. I'm skeptical of implants in this area only because I haven't seen any results but in theory I don't see why they wouldn't work well.
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How many custom implant results have you seen exactly? Without that information, and information regarding their placement and the patients' bodyfat levels if you have seen any, you are not qualified to come to that conclusion. If you have seen results of high placed custom zygomatic implants in men with low bodyfat levels, I take that all back and I'm interested to hear more.
No that's true, I've only seen what is available online. I'm sure there are good implant results that I haven't seen but until I do lay my eyes on them I am cautiously pessimistic.
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No that's true, I've only seen what is available online. I'm sure there are good implant results that I haven't seen but until I do lay my eyes on them I am cautiously pessimistic.
I share the same general viewpoint except that I'm cautiously optimistic - there aren't results online at all as far as I'm aware. I don't see why they wouldn't work - I've seen excellent and natural looking results in low body fat males for custom brow, forehead and jaw augmebtation so I don't see why proper zygomatic implant design wouldn't work aesthetically.
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Ive been deeply researching implants for the midface because ive seen lots of mediocre results on men. Malar implants seem to give a strange effect on men with moderate sub cutanous fat, pushing it all forward (an example can be seen on yaremchuks website)
Ive decided that infra obital rim implants will be the most natural looking and give the best results, increasing projection of the infraorbital rim all the way out towards the zygomatic arch or even the lateral orbital rim.
http://www.stryker.com/en-us/gsdamretirement/index.htmstellent/groups/public/documents/web_prod/141937.pdf
The catalogue includes infra orbital rim implants, extended orbital rim implants, midface contour and midface rim implants. My surgeon recommended the midface rim, but it only gives 3mm of forward projection. not sure if that will be enough, but i suppose with implants, less is more.
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Ive been deeply researching implants for the midface because ive seen lots of mediocre results on men. Malar implants seem to give a strange effect on men with moderate sub cutanous fat, pushing it all forward (an example can be seen on yaremchuks website)
Ive decided that infra obital rim implants will be the most natural looking and give the best results, increasing projection of the infraorbital rim all the way out towards the zygomatic arch or even the lateral orbital rim.
http://www.stryker.com/en-us/gsdamretirement/index.htmstellent/groups/public/documents/web_prod/141937.pdf
The catalogue includes infra orbital rim implants, extended orbital rim implants, midface contour and midface rim implants. My surgeon recommended the midface rim, but it only gives 3mm of forward projection. not sure if that will be enough, but i suppose with implants, less is more.
It's strange that you don't mention custom implants.
The reason why most malar implants have that effect is because the implants are placed too low down on the (often times already low set) zygos. The only way to achieve a good result with these implants is to have them custom made, and for the implant prominence to be placed as far up the zygomatic body as possible so that it is basically touching the lower half of the lateral orbital rim. This may require actually raising the orbital rim itself to bring it closer to the lower eyelid margin. And then have it stretching out along the zygomatic arches. This is all speculation however as I've never ever seen this done. Also if the natural zygomatic prominence is low set, bone burring of that prominence in favour of the new one created by the implant may be necessary otherwise it may end up looking odd? I'm not too sure but in theory it makes sense.