The real surgery you need for a more 3D, sculpted face

[erin.culzz]

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Kinda depressing she underwent bimaxillary anterior segmental osteotomy with 4 mm recession and 3 mm downward and the changes aren't that impressive......like her face still looks flat and wide to me. But this is also 6 months post op so maybe she's still swollen.

Ps, not sure if it's makeup or the angle...but she looks less "angry" in the bottom row - like mouth and eye area seem more relaxed? So I guess that's a plus.

I actually like the protruded mouths. Makes your smile wider, and gives you a babyface... Maybe she couldve got facelift and chin implant? Her weak chin looks like the main problem.

 

[smallface]

I actually like the protruded mouths. Makes your smile wider, and gives you a babyface... Maybe she couldve got facelift and chin implant? Her weak chin looks like the main problem.

Judging from the profile view, it looked like she couldn't close her lips naturally so perhaps why she had it done. I do like the overall harmony in her profile post surgery - the line from eye to mouth is straight and her jaw looks more defined

 

[smallface]

Lol, I thought I was the only one who was so critical about facial features. I did my procedures back in 2009-2011, so I had already done all of this research.

For a Korean, my face wasn't really all that flat, but still flatter compared with normal Caucasian faces. I had a very slight underbite (class 3 malocclusion) which wasn't really bothering me functionally, but was enough for insurance to step in and cover the maxillofacial surgery. They would only cover LeFort I, although a LeFort II would have been nice. LeFort III seems like it would just push your entire anterior portion of your face forward, so not really solving the "lack of projection" issue. If you're going for the Caucasion look, then you would need to project your midface via LeFort II, then probably push back your upper lip/premaxilla via LeFort I. So for the extremely flat severe case, you would probably need to do a combination of LeFort II anterior projection, and a LeFort I posterior retrusion, to emulate a Caucasian face which has a projected the midface, but flat and retruded upper lip area. Asians generally can have the opposite features where the midface is pushed back, yet the upper lip area projects out like a chimp with a prominent lower jaw. Also, Asian faces can tend to be long vertically. Although technically you can shrink the LeFort I area by removing part of the bone vertically to make the face shorter, the real issue lies in your soft tissues (skin). There's no way to really vertically reduce your soft tissues like you can with bone. So if you were to shorten that bone, you still would have a tall upper lip and when you smile, your visible teeth is in the wrong place now. No real easy fix, unfortunately. As far as facial definition goes, Asians tend to have thicker skin, so any underlying structure will not come through as easily as it does for Caucasians.

Also keep in mind that many doctors, especially those in the US, may not perform these LeFort procedures unless they deem it medically necessary, even if you're willing to pay out of pocket. The more advanced LeForts like the LeFort III may need access near your eyes and there are always risks that most rational doctors won't take on, even if the risks might be acceptable to you and me. It's a lengthy and committed process too, where you need to coordinate with your orthodontist to possibly get on braces and align your teeth perfectly. Post-operative care also requires you to have your mouth wired shut eating out of a straw for months for the bones to fully heal too.

I ended up doing a LeFort I rotation and reduction of the lower jaw to solve the bite problem. My face didn't have that stereotypical flat Asian face, so I don't think I really needed a LeFort II. A couple of years later, I had eyelid surgery done, followed by augmentation rhinoplasty with rib cartilage, enhancing both the entire bridge and the columella extension. I had a deviated septum, so we knocked two birds with one stone and insurance covered most of the procedure. The rhino had an added benefit of simulating an epicanthoplasty procedure from the raised bridge stretching the skin around the inner part of the eyes.

I'm now looking into possibly doing a forehead procedure. I have defined brow areas giving that deep-set eyes look, but looking to fill out the forehead area above them.

Just sharing some feedback and experience that might help some people here.

Thanks for sharing! Haven't come across anyone who's undergone lf on this forum so this is really really helpful.

Currently my lip/smile covers half my teeth so I'm not sure how it will be after surgery - thinking of getting philtrum shortened to expose more teeth. And yes unfortunately I have rhino thick Asian skin so I'm going to really need the most dramatic projection for some definition to come thru.

And I thought I'd have to get epi but I realize when I do my nose and pull my face forward those extra skin flaps will disappear so that's one "free" surgery lol

Do you mind sharing which surgeons you went to for your lefort? And would they be willing to do lf2 for aesthetic reasons?

Also did the surgery cause any slight complications with your mouth or change the way your tongue rests/accidentally biting inner cheeks/lips/tongue when eating?

 

[ginajin]

interesting topic

 

[paul80]

Thanks for sharing! Haven't come across anyone who's undergone lf on this forum so this is really really helpful.

Currently my lip/smile covers half my teeth so I'm not sure how it will be after surgery - thinking of getting philtrum shortened to expose more teeth. And yes unfortunately I have rhino thick Asian skin so I'm going to really need the most dramatic projection for some definition to come thru.

And I thought I'd have to get epi but I realize when I do my nose and pull my face forward those extra skin flaps will disappear so that's one "free" surgery lol

Do you mind sharing which surgeons you went to for your lefort? And would they be willing to do lf2 for aesthetic reasons?

Also did the surgery cause any slight complications with your mouth or change the way your tongue rests/accidentally biting inner cheeks/lips/tongue when eating?

No problem!

Many people who get their underbite/overbite fixed undergo a LeFort I. Some just adjust the lower mandible portion and leave the maxilla part alone to minimize the amount of surgery. But while I wanted my bite fixed, I also wanted to maximize the aesthetic improvement, because, why not (and kill 2 birds). There's usually more than one way to skin the cat, in terms of maxilla and mandible movements, as long as the teeth meet properly. Both pieces can be moved anterior/posterior, superior/inferior, and also rotated downward/upward as well (as long as they meet, the bite is considered fixed). I had my LeFort I done in 2009 by Dr. Mario Capuano on Long Island, NY. Keep in mind that many doctors are extremely prideful and set in their ways. You probe and ask certain questions and they get all offended since they don't like the fact that you may know something they don't. Or you challenge them, and they feel insulted. For example, I consulted with a doc in NYC who showed me his idea of a proper before/after projected outcome and although the teeth met fine, he projected my maxilla and mandible excessively forward and I looked like a chimp. He wouldn't budge from his surgical plan. That's why I went with Capuano. Not only did he agree with my sense of aesthetics (posterior retruded maxilla and mandible, and rotated downward), he was willing to work with me on the aesthetics, as long as the bite got fixed. We also did a minor sliding genioplasty to give the chin a little definition (I try to avoid implants where possible). He admitted I was one of his pickiest patients and I felt bad he had to put up with me lol. In regards to a LeFort II for a non-functional reason, I kind of doubt most docs would go for it. Docs especially in the US tend to play it safer, are more conservative, and risk-averse. Even if you were willing to pay all cash, I still don't know. I had a functional need for a LeFort I, so while he was fixing my underbite issue, he also maximized the aesthetics while he was at it. A LeFort I is a pretty common procedure. I suspect a LeFort II isn't, and while it can be used to dramatically improve aesthetics, it's usually only done to fix a congenital condition or severe trauma to the face. You can always do a consult and ask. And btw, my mouth felt natural after the surgery, no odd feeling.

Yep, a raised bridge would give you some epi pull. My tapered crease eyelids became more like parallel creases which is an improvement imo, and you can see the whites in the inner corners of your eyes better. I used Dr. Thomas Le in Ellicott City, MD for my rib cartilage augmentation rhinoplasty back in 2011. He raised the bridge, projected the tip with a columella strut, lowered the columella so the center of the nose is pushed downward (you see the columella from the profile view), and projected the subnasale (where the top of the upper lip meets the bottom of the nose) forward (since Asians tend to have short nasal spines). Keep in mind that for Asians, any underlying change (skeletal/cartilage) you want visible on the outside, needs to be more dramatic underneath since we have thicker skin and soft tissue that conceals any kind of definition.

 

[o_0h]

I think her end look turned out great (in comparison to original look) but perhaps she can tone down the lip filler so it doesn't appear comical. But otherwise it's incredible how she went from Asian to Latina with surgery although to be fair, she didn't have a heavily stereotypical Asian face to begin with. I think she looks good in some angles but I guess the real test is how it comes across in real life when she's talking etc. If anyone knows the surgeons she went to...pls share

Woman from South Korea spends whopping $60k on surgery to look like Kim Kardashian; See results

This is not the first time a woman has shelled out a huge amount to resemble none other than Kim Kardashian.

me.mashable.com

Uhh is it just me or does she look a lot worse after? Very very fake and uncanny valley. There's nothing wrong in my opinion with looking Asian, I prefer to keep my ethnic identity apparent in my face.

 

[guy8989]

Interesting. Is it because of discomfort or they just didn't like the look?

Rhinoplasty does add dimension but if your glabellar area is also flat and your overall face is flat, it can look a little out of place, like just a tall nose rising out of nowhere lol iygwim

I had "midface augmentation" or paranasal augmentation and I can tell you first-hand that it's uncomfortable as you will always feel there's something in your upper lip and it's ugly too as it has restricted my smile and made my smile smaller, uglier, unnatural-looking and stiff. I literally feel tired from smiling too big too long because of the restriction the graft that's been placed in my midface. I'm dying to get it removed and undo the midface augmentation asap once I've found the right clinic and doctor to do it.

 

[ps4479]

I had "midface augmentation" or paranasal augmentation and I can tell you first-hand that it's uncomfortable as you will always feel there's something in your upper lip and it's ugly too as it has restricted my smile and made my smile smaller, uglier, unnatural-looking and stiff. I literally feel tired from smiling too big too long because of the restriction the graft that's been placed in my midface. I'm dying to get it removed and undo the midface augmentation asap once I've found the right clinic and doctor to do it.

what material did you use for the paranasal augmentation?

 

[tweedledee]

Angelababy looks good because her face is 3D but Wonyoung looks good because hers is flat. It is totally case by case.