7.5 MARPE for Cheekbone Enhancement
From Boys to Men
One Aesthetic Upside of MARPE
In previous chapters we discussed the aesthetic risks posed by MARPE.
We identified asymmetry and maxillary vertical excess as major aesthetic risks. (Of course, asymmetry and vertical excess pose functional problems, too.)
In this chapter we will focus on a potential aesthetic upside of MARPE, which is cheekbone enhancement.
Who is a Good Candidate for Cheekbone Enhancement?
For the right kind of patient, the effect of MARPE on the midface can be quite nice. Such a patient would meet the following criteria:
Relatively flat midface to begin with
Otherwise, why fix what’s not broken?
No pre-existing asymmetry
As we know, MARPE can make existing asymmetries much worse. What good are prominent cheekbones if they sit atop an asymmetric mess? In fact, the prominent cheekbones might even magnify the asymmetry.
No pre-existing vertical maxillary excess
MARPE also exacerbates vertical maxillary excess. What good is cheekbone angularity if it comes at the cost of a long face and gummy smile?
Example of maxillary excess (and gummy smile). Source: Medigraphic
Normal sized mandible, so that midfacial expansion does not result in balloon face
Harmony is key to aesthetics. For a patient whose midface is already large compared to their lower jaw, MARPE can result in a top-heavy, V-shaped aesthetic that I call “balloon face.”
Source: Solstice Sunglasses
Low body fat, so that subtle bony changes are actually visible
The subtle bony changes MARPE makes to the midface (in a safe, moderate expansion) would be invisible if buried under lots of facial fat.
For both men and women meeting the criteria above, a modest MARPE expansion can be an aesthetic boon.
Boyz II Men
The patients I find to be happiest with post-MARPE aesthetics are young males with boyish faces.
Their sentiment after MARPE is something like, “I look more masculine now,” “I look more my age, and less like a boy,” or “I feel more alpha.”