FIRST QUARTER 2000, VOLUME 14, NO 1

Sculpting the contour of the face with facial plastic surgery

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Sculpting the contour of the face with facial plastic surgery

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What do you see when you look in the mirror? A pleasing appearance? Or one feature that seems to dominate your whole face? If your facial harmony is disturbed by a large nose, a receding chin, flat cheeks, or sagging jowls, you may benefit from one or more of a number of facial contouring procedures designed to give the face a balanced, harmonious appearance.

Profile plasty
Facial plastic surgeons refer to procedures to balance the nose and chin as profile plasty. Profile plasty can make a dramatic difference in your profile, reducing a prominent nose and bringing the chin and brow into balance.

Most people never see their own profile, so often they are not aware of how their features affect their facial harmony. Typically, a patient will consult a facial plastic surgeon wanting a procedure to reduce the size of his or her nose. By analyzing the facial profile, the surgeon may determine that the nose’s appearance is exaggerated because of an underdeveloped chin or a sloping brow. In this case, a combination of procedures that addresses all the aspects of facial balance can yield the best results.

Chin augmentation moving the bone or placing a small implant at the point of the chin often is recommended in conjunction with nasal surgery. It also can be done alone, or in conjunction with a facelift, liposuction of the face or neck, or other facial procedures. The relatively minor procedure can make a big difference in your profile, and it may even make it possible for the surgeon to do less to the nose while achieving a pleasing facial harmony.

Augmenting the midface region
Your cheekbones, the soft tissues of the midface, and the fat pads of the cheeks are another important part of your facial contour. Underdeveloped cheekbones can make your nose appear more prominent than it is. They also may contribute to premature aging. The fat pads of the cheeks and other soft tissues tend to slip down with age, causing hollow depressions to appear below the cheeks. Although this can happen to anyone, the problem may occur at an earlier age if the bone structure is inadequate.

Several types of implants may be used to augment the midface region. Constructed of a surgical-grade synthetic material, implants are available in varying sizes to improve the bone structure, correct specific problems, and augment the soft tissues of the midface.

Although midfacial implants are sometimes done in conjunction with facelift surgery, they may not be needed if you have one of the new, deeper facelifts. In a deep-plane facelift, the fat pad is moved upward into its more natural position to enhance the projection of the cheek.

Refining the chin and jaw
A weak chin or jaw not only disturbs facial harmony, it also can contribute to premature signs of aging. For example, an underdeveloped lower jaw, combined with loose skin and excess fatty tissue in the neck area, can cause an undesirable jowly appearance. To correct the problem, your facial plastic surgeon may advise chin augmentation combined with liposuction to remove the excess fat. These may be done in conjunction with other facial rejuvenation procedures in order to refine the angle of the chin and jaw.

In some people, deep grooves form from each corner of the lip down to the chin. These so-called marionette lines can be corrected by placing small implants along each side of the jaw, just in front of the jowl. When done along with a facelift, these implants eliminate unwanted lines and provide a more youthful jawline.

Other contouring procedures
A number of other procedures are also available to improve the contours of the face. For example, ear surgery may be recommended to reposition or reshape unattractive ears. Chin reduction can reduce the size of a chin that is too prominent. Liposuction is done to remove excess fatty deposits from the neck or jowl area. Necklift surgery can correct a sunken appearance in the throat area and eliminate turkey neck. See your facial plastic surgeon for more information about how facial contouring may help you.