Questions about mid-face hypoplasia and fixing it. (Overall profile improvemen )

[Keoro]

I seem to have inherited exorbitism ( bulgy eyes ) - exophtalmos which i asked about in Realself hoping to get some answers, apparently the problem is my deficient bony orbital rim and flat hypoplasia face, combined with a flatnose/receding chin makes for a very unmasculine face which frankly is bothersome. I'm thinking about a chin implant to at least fix my receding chin, but the problem from what i've heard from experts seems to be a deficient bony orbital rim and lack of cheek bones which contributes to the severity of my exophtalmos. I'm really looking for a way to accentuate my jaw lines, my face seems to be pretty oval. I'm certain a chin implant would at least help improve projection. Thank you for reading.

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[Keoro]

Bump. Anyone?

[Keoro]

Bump again. Le-fort 3? Genioplasty? Le-fort 1? Malar osteotomy? You're the experts guys, would appreciate any answer

[PloskoPlus]

Bump again. Le-fort 3? Genioplasty? Le-fort 1? Malar osteotomy? You're the experts guys, would appreciate any answer

Modified Le Fort 3 + chin wing.

[Rico]

http://www.ncbi.nlm.nih.gov/pubmed/7699077

What about this ?

PS Not only Mommaerts performs this kind of surgery
Names are in medical article

[Alue]

It's been discussed in length in other threads. 
A lot of people come in here claiming they need it, but you do look like you have a actual case for orbital/malar advancement. 

http://jawsurgeryforums.com/index.php/topic,4198.0.html
http://jawsurgeryforums.com/index.php/topic,3933.0.html

[PloskoPlus]

OP is similar case as me, but I have more severe everything.otherwise,LF3.

No man, I really don't think so.

[Keoro]

Realistically, a Sliding genioplasty + Malar osteotomy would do alot of good?

[Rico]

I think all of you do not know what is behind term "malar osteotomy"  it is mobilising the whole zygomatic bone. Part of this bone creates orbital floor, hence orbital volume may change what may cause enopthalmos. And at least 50% of  maxillo-facial surgeons (even very experienced, well known) won't do this on you.

The alternative method (not as effcient as full malar osteotomy, but more safe) is zygomatic sandwich osteotomy which can be used (I do not know how, I gave link, you have to buy this article, or find full version) to treat kinda recessed cheekbones probably in 2 directions.

Of course implants are 3rd option

PS If you find such surgeon who has performed a lot of malar osteotomies please let me know.  Now I know only Prof. Iannetti from Rome  (he has at least documented this)

[PloskoPlus]

Realistically, a Sliding genioplasty + Malar osteotomy would do alot of good?

I think Rico is right - malar osteotomy is not zygomatic osteotomy, which is what you probably really mean.  A ZO will widen your face, but not solve your under-eye area at all.  But your lower jaw is narrow, which a ZO will make look even more narrow.  A genio would improve your profile, but that's about it. IMO, you would really benefit from a chin wing - it would improve your whole lower jaw contour.  Alternatively genioplasty + jaw implants.  But aesthetically the eye area is the most important...  Modified LFIII.

[Keoro]

Just realized i have an overbite ;(

[PloskoPlus]

Just realized i have an overbite ;(

Post pics of yourself smiling front, side, 3/4.  A few mm of overjet is normal.

[Rico]

hmm I suppose modified LFIII is very close to typical malar osteotomy, am I right ?

or in other words. If modified LF3 risk list contains enophtalmos and diploplia, then for sure it is very close.
Who knows anything about the risks of modified LF3 procedure  ?

[PloskoPlus]

hmm I suppose modified LFIII is very close to typical malar osteotomy, am I right ?

or in other words. If modified LF3 risk list contains enophtalmos and diploplia, then for sure it is very close.
Who knows anything about the risks of modified LF3 procedure  ?

Read earl25's modified lefort iii threads.

[Rico]

I wonder what is this : https://www.researchgate.net/publication/49646858_Zygomatic_sagittal_split_osteotomy_a_novel_and_simple_surgical_technique_for_use_in_midface_corrections