Design principles for custom cheek and jaw implants

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Merlix

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I'm in the process of designing custom cheek and jaw/chin implants so I'm trying to figure out what principles I should use to determine the right projections. In all cases I'm using the bone 3d CT scan without a soft tissue overlay.

I'm sure the doctor will have his own ideas but I wanted to go into it with scientifically proven principles so any help with this would be appreciated.

For cheek:

Increase lateral projection such that the FWHR ratio is maximised (up to 2) but the ES ratio doesn't fall below 0.42. Err on the side of underprojecting to account for variability of soft tissue change (and likely less than 3.5mm in any case).

Anterior projection around 3.5mm maximum.

Zygomatic arch enhancement should wrap around entirety of lateral cheek all the way to ear. Aim for sayan-like shape.

For jaw/chin:

Increase chin width to at least the distance between canine teeth but potentially more, to around mouth width (can't see mouth with bone scan though). Chin should have some flanging on corners to square chin and avoid rounded chin.

Increase chin height such that the chin height to philtrum ratio is 2 using bone scan, which would go even higher after accounting for soft tissue overlay at bottom of chin, but no greater than 2.25. Also accounting for increase height, the lower third should be no greater than 10% more than midface third, else long face will develop.

Increase chin projection such that tip of chin vertically aligns with at least bottom lip (which in turn is slightly behind my upper lip) erring on side of greater projection but no greater than vertically aligning with top lip.

Gonions should be horizontally at mouth opening level, erring on slightly lower but no lower than horizontally below bottom lip (will need to estimate based on bone scan). Gonial angle will then be determined based on this level and chin height but should be around 120-130 degrees, ideally 125.

Jaw width should be around 92-95% of cheek width, erring on higher but no higher than 100% in any case (will need to be estimated based on bone scan and variability of soft tissue changes).

Generally speaking, since I have big lips and mouth I think I can generally err on too large a chin and jaw since it won't look strange.

Any opinions are welcome. Thanks.
 
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Very interesting especially for zygo implants

Sadly I am not so knowledge on implants
I give you a bump though
 
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This is an underrated topic of discussion. I know a few people here have worked with CAD software to design implants.
 
@GordonFreeman you were also getting custom cheek implants right ?
Can you share your opinion here.
 
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Very interesting especially for zygo implants

Sadly I am not so knowledge on implants
I give you a bump though

Ya I think I have all aspects of the jaw/chin nailed down (the only variability is soft tissue interaction and degree of flanging of chin corners for width and Sharpness) but not sure what else I should be thinking about with respect to the cheek implants. I'd say just aim for saiyan-like shape and hope my skin isn't too thick.
 
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Ya I think I have all aspects of the jaw/chin nailed down (the only variability is soft tissue interaction and degree of flanging of chin corners for width and Sharpness) but not sure what else I should be thinking about with respect to the cheek implants. I'd say just aim for saiyan-like shape and hope my skin isn't too thick.
If we can stretch our skin easily does this mean its not thick and implant will look good ?
 
If we can stretch our skin easily does this mean its not thick and implant will look good ?

I think one way is to look at the tip of your nose and if you can see the cartilage then you have thin skin. Oily skin with large pores is also indicative of thick skin.

Thick skin generally leads to less defined edges on the implants which is bad, but the improvement to face framing is still dramatic if done right.
 
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3.5mm as the maximum projection on the cheek implants seems a bit conservative, based on the designs I’ve come across, and I would probably go a bit bigger- especially if you are naturally “flat” in that area. However, if your cheekbones are already decent, perhaps the conservative route would best suit you. I’ve talked with one user here who had custom infraorbital/zygomatic implants that were 7-8mm at their point of maximum prominence, and he said his results are great, but that he also had a severely flat bone structure in that area originally that he had to compensate for.
 
I'm in the process of designing custom cheek and jaw/chin implants so I'm trying to figure out what principles I should use to determine the right projections. In all cases I'm using the bone 3d CT scan without a soft tissue overlay.

I'm sure the doctor will have his own ideas but I wanted to go into it with scientifically proven principles so any help with this would be appreciated.

For cheek:

Increase lateral projection such that the FWHR ratio is maximised (up to 2) but the ES ratio doesn't fall below 0.42. Err on the side of underprojecting to account for variability of soft tissue change (and likely less than 3.5mm in any case).

Anterior projection around 3.5mm maximum.

Zygomatic arch enhancement should wrap around entirety of lateral cheek all the way to ear. Aim for sayan-like shape.

For jaw/chin:

Increase chin width to at least the distance between canine teeth but potentially more, to around mouth width (can't see mouth with bone scan though). Chin should have some flanging on corners to square chin and avoid rounded chin.

Increase chin height such that the chin height to philtrum ratio is 2 using bone scan, which would go even higher after accounting for soft tissue overlay at bottom of chin, but no greater than 2.25. Also accounting for increase height, the lower third should be no greater than 10% more than midface third, else long face will develop.

Increase chin projection such that tip of chin vertically aligns with at least bottom lip (which in turn is slightly behind my upper lip) erring on side of greater projection but no greater than vertically aligning with top lip.

Gonions should be horizontally at mouth opening level, erring on slightly lower but no lower than horizontally below bottom lip (will need to estimate based on bone scan). Gonial angle will then be determined based on this level and chin height but should be around 120-130 degrees, ideally 125.

Jaw width should be around 92-95% of cheek width, erring on higher but no higher than 100% in any case (will need to be estimated based on bone scan and variability of soft tissue changes).

Generally speaking, since I have big lips and mouth I think I can generally err on too large a chin and jaw since it won't look strange.

Any opinions are welcome. Thanks.

Any pics? You can only get so far with mathematical principles, they are general, not a rule. What looks good on one person may not look good on another.
 
Any pics? You can only get so far with mathematical principles, they are general, not a rule. What looks good on one person may not look good on another.

How would seeing my pictures change the optimal ratios of the jawline/chin? Ratios are by their nature objective since they rely on relationships between different parts of the face.

I can see it being more useful for the cheeks though (regarding maximum projection) so I'll upload them.

BTW my doc said 3.5mm projection on the cheeks was generally the maximum without increasing odds of revision (because they look unnatural). I suppose that's the risk to take for potentially better results.
 
3.5mm as the maximum projection on the cheek implants seems a bit conservative, based on the designs I’ve come across, and I would probably go a bit bigger- especially if you are naturally “flat” in that area. However, if your cheekbones are already decent, perhaps the conservative route would best suit you. I’ve talked with one user here who had custom infraorbital/zygomatic implants that were 7-8mm at their point of maximum prominence, and he said his results are great, but that he also had a severely flat bone structure in that area originally that he had to compensate for.

I'm somewhat skeptical of self reported results, unless you saw clear front, profile and 3/4 pictures.

The reason being is that a guy with freak show cheeks or jaw won't say he looks like a freak show (like some of eppley's creations) but to any normal person you can tell something is off and that is worse than an underwhelming result.
 
How would seeing my pictures change the optimal ratios of the jawline/chin? Ratios are by their nature objective since they rely on relationships between different parts of the face.

I can see it being more useful for the cheeks though (regarding maximum projection) so I'll upload them.

BTW my doc said 3.5mm projection on the cheeks was generally the maximum without increasing odds of revision (because they look unnatural). I suppose that's the risk to take for potentially better results.
Just measure Pitt and there you go
 
Just measure Pitt and there you go

His gonions are a bit too low and jaw a bit too flared, but generally speaking the ratios I used are consistent with his facial proportions.

I'm just curious as to which ratios need additional limitations placed on them or if I'm missing something.

For example, of course I'd love to have my cheeks laterally widen to where my fwhr is 1.8 like pitt's (then I could correspondingly increase my jaw width too) but then my ES ratio would be fucked and my temples/forehead would be severely egg shaped so it would be totally fucked. Even if I got temple fillers it would look fucked. Hence the natural 3.5mm limitation placed on the projection despite a desire for additional fwhr.
 
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His gonions are a bit too low and jaw a bit too flared, but generally speaking the ratios I used are consistent with his facial proportions.

I'm just curious as to which ratios need additional limitations placed on them or if I'm missing something.

For example, of course I'd love to have my cheeks laterally widen to where my fwhr is 1.8 like pitt's (then I could correspondingly increase my jaw width too) but then my ES ratio would be fucked and my temples/forehead would be severely egg shaped so it would be totally fucked. Even if I got temple fillers it would look fucked. Hence the natural 3.5mm limitation placed on the projection despite a desire for additional fwhr.
Pitt is ideal in everything, if you don’t use Pitt use Tyler Brady
5D99476F 049F 4BE5 84F7 5DD3B89983EB
 
Bumping this for more critiques.
 
Surprised more people don't care about this. Implants = cope?
 
I'm in the process of designing custom cheek and jaw/chin implants so I'm trying to figure out what principles I should use to determine the right projections. In all cases I'm using the bone 3d CT scan without a soft tissue overlay.

I'm sure the doctor will have his own ideas but I wanted to go into it with scientifically proven principles so any help with this would be appreciated.

For cheek:

Increase lateral projection such that the FWHR ratio is maximised (up to 2) but the ES ratio doesn't fall below 0.42. Err on the side of underprojecting to account for variability of soft tissue change (and likely less than 3.5mm in any case).

Anterior projection around 3.5mm maximum.

Zygomatic arch enhancement should wrap around entirety of lateral cheek all the way to ear. Aim for sayan-like shape.

For jaw/chin:

Increase chin width to at least the distance between canine teeth but potentially more, to around mouth width (can't see mouth with bone scan though). Chin should have some flanging on corners to square chin and avoid rounded chin.

Increase chin height such that the chin height to philtrum ratio is 2 using bone scan, which would go even higher after accounting for soft tissue overlay at bottom of chin, but no greater than 2.25. Also accounting for increase height, the lower third should be no greater than 10% more than midface third, else long face will develop.

Increase chin projection such that tip of chin vertically aligns with at least bottom lip (which in turn is slightly behind my upper lip) erring on side of greater projection but no greater than vertically aligning with top lip.

Gonions should be horizontally at mouth opening level, erring on slightly lower but no lower than horizontally below bottom lip (will need to estimate based on bone scan). Gonial angle will then be determined based on this level and chin height but should be around 120-130 degrees, ideally 125.

Jaw width should be around 92-95% of cheek width, erring on higher but no higher than 100% in any case (will need to be estimated based on bone scan and variability of soft tissue changes).

Generally speaking, since I have big lips and mouth I think I can generally err on too large a chin and jaw since it won't look strange.

Any opinions are welcome. Thanks.


Implants for the lower third is a meme, get osteotomies like a bimax, far better results and health benefits , even improves other areas of the face i.e. nose and eyes.

Surgeons do shit like chin implants as it's easy quick money, and most patients want something simple.
 
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Implants for the lower third is a meme, get osteotomies like a bimax, far better results and health benefits , even improves other areas of the face i.e. nose and eyes.

I emulate the result of a bimax by maximally jutting my jaw and its still pretty shit and underwhelming. Plus I don't have time for years of braces.
 
I emulate the result of a bimax by maximally jutting my jaw and its still pretty shit and underwhelming. Plus I don't have time for years of braces.

If you havnt got the time to do it properly then don't do it at all. A lot of surgeons do surgery first and braces after.

Jutting does not simulate a bimax.

Search the archives and research first before you become a Dr Eppley implant victim.


This look like jutting to you?

Screenshot 20200629 161434 Chrome


Screenshot 20200629 161446 Chrome


Dr Joel Defrancq 1457273981020278600 6259 1


C4wih68rau66


Here's some implant work

Dr Joel Defrancq 1534585488007334300 2631
 
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