RECONTOURING THE FACE

M. TAVALLALI, M.D.

The facial anatomy of each of us develops while we are still in our mother’s wombs. At the time of birth, infants typically have broad foreheads, small noses, and small chins. Facial skeletal growth continues well into our teenage years, with the majority of the growth having been completed at age 14-16 in females, and 16-18 in males. From here on, although the skeleton does not grow appreciably, the soft tissues of the face (skin and muscle) undergo changes brought about by damage to the skin by sun and environment, or by the effects of gravity.

For patients interested in changing their facial skeleton, the procedure can be divided into two main groups. First there are procedures designed to change the size and shape of the cheeks and cheekbones, and second, those that change the size or shape of the chin. A number of other procedures exist whereby Dr. Tavallali can change the shape of the nose (Rhinoplasty) or forehead. Cheeks can be either enlarged or made smaller by the addition or removal of fat. There is a fat pad in each cheek which gives the fullness to the cheeks that some patients have. These can be removed surgically to thin the cheek area and make the face more elongated or thinner in appearance. For those with particularly sunken cheeks, fat that is removed from other parts of the body can be injected into the face with about a 70% survival, and although a repeat procedure is not uncommon, the final results can be very pleasing.

For those patients wishing an enlargement or change in the shape of the cheekbones, a variety of implants have been developed which can be placed over the natural bone, to enlarge the area and provide the patient with higher cheeks. These implants can be placed either through incisions in the mouth, or through incisions under the eye. They are available in a number of shapes, and the plastic surgeon usually sculpts them to provide the desired effect for the patient’s face. Both these procedures are outpatient surgeries performed in the office or surgical center under local or general anesthesia. Although some swelling can be expected for a few days, there is minimal discomfort, which is easily controlled with pain medication.

The chin can be surgically altered in shape and size by a number of techniques. The most common involves placement of a small implant over the prominence of the chin to increase the chin projection and bring the whole contour of the face more in harmony. Many patients who are interested in rhinoplasty (surgery of the nose) can also benefit from a chin augmentation, since a definite and important relationship exists between the chin and nasal shapes. The implants are placed through incisions in either the mouth or under the chin under local or general anesthesia. Again the surgery can be performed as an outpatient in an office or surgical center, and patients are able to resume normal activities within 2-3 days.

For those patients who have particularly small or large chins, the techniques are more involved and require general anesthesia. In these cases, the bone is either reduced surgically if the chin is large, or the bone is moved in the desired direction (usually up and forward) if the chin is small. These procedures are also carried out through incisions in the mouth as outpatient surgeries, but the recovery period is closer to one week.

For patients requesting improvement with facial lines, thin lips, or deep wrinkles, a number of techniques are also available. Collagen injections are perhaps the most common method, but suffer from the disadvantage that the improvement is strictly temporary lasting three months at most. Some individuals are also allergic to the collagen protein and are not candidates for this method. Fat injections, with fat harvested from the patient’s own body is a more natural way of recontouring the face. Although more than one set of injections may be necessary to achieve the desired result, the fat has a more long lasting effect and has no risk of rejection. Fat injections can be used to improve the facial lines between the cheeks and the nose and lips, deep wrinkles that are not improved by specialized laser treatments, as well as to enlarge lips.

Another series of methods which are available, use synthetic materials which are implanted under the skin to achieve the same results as with fat injections but with a more permanent result, usually requiring only one surgical procedure. Thin strips of these synthetics are placed under facial lines, or under the lips in order to enlarge them.

The procedures discussed above include some of the latest techniques available for facial improvement as well as some which have stood the test of time.

Hopefully, this information has given you a better understanding of facial recontouring. Please fell free to call our offices at 703-876-9400 or 301-907-3838 to schedule a complimentary consultation. I look forward to seeing you then.

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