Facial contouring
procedures are used to restore facial contour,
which has been lost, by aging, surgery, or trauma or to enhance
facial features
which were congenitally misshapen, malpositioined, or un-esthetically
proportioned. This can apply to almost any area of the face, but
typically
involves the major features including the ears, cheeks, chin, lips,
nose, neck,
or facial skin.A full, convex mid-face or cheek is an important
feature to a youthful and attractive face. This is an area that
tends to flatten and lose volume early in the aging process and
in addition, many individuals are born with inadequate bony contour
in this area. This can be corrected with malar (cheek) or sub-malar
implants, as well as autologous fat transplantation and injectable
fillers.
A
strong and smooth jaw line, including the chin, has
adequate volume in the attractive, youthful face. Many individuals are born with a weak chin, which
results in poor aging in the lower part of the face, as well as
an imbalance in the facial profile, while other individuals lose
the volume of their chin as a result of the aging process. The chin
can be contoured and volumized primarily by the use of
solid chin implants. We favor the use of extended chin implants
to not just add projections to the chin, but to gently and naturally
contour the front of the jaw. Fat injections and lifting
procedures are also used to correct chin deformities.
This is a small surgical procedure performed under local anesthesia in the office setting. A narrow wedge of skin is excised from the white portion of the upper lift, just below the nose, which results in elevation and shaping of the upper lip. The resultant scar lies in the crease between the nose and the lip and is imperceptible. Fillers or autologous fat are often used in conjunction with this procedure to add volume to the lips.
Full
lips are strongly associated with facial attractiveness and
youth. Some individuals are born with hypoplastic or thin lips
and due to the activity of the lips, they show aging
both in their texture, as well as their volume, and tend
to thin over time. Lips can be rejuvenated and contoured by lifting
(Lip Lift), injectable fillers, autologous fat transplantation,
and surgically implanted soft tissue fillers.
A well defined angle between the jaw and neck, as
well as definition of the jaw line, is a sign of facial
youth and attractiveness. Neck contouring is aaccomplished through three small incisions, one under the chin and one behind each earlobe. Small cannulas are introduced to selecively remove and sculpt, and sometimes reinsert, fat into the areas along the jaw line and in the neck to improve its contour.Thin, tight pored skin is the ideal in terms of
attractiveness, although this skin is very susceptible to damage from sun exposure and other factors and tends to not age well. Acne prone
skin has large pores and is subject to scarring as a result of acne
infection. In addition, generalized skin aging results in a lack
of tone and laxity of the skin. Both photo rejuvenation and resurfacing,
using dermabrasion, lasers or
chemical peels can be performed to re-contour the skin. This results
in skin that
is smoother, more even in tone and more luminescent or reflective
of light.
There are two types of (non-autologous fat) soft tissue augmentation materials and fillers: those that require surgical placement such Alloderm® and Advanta™ and those that are injectable. We have chosen several injectable fillers including Radiesse™, Jevederm Ultra®, Ultra Plus®, and the Restylane® family of products (Restylane®, Restylane® Fine Line, Perlane®), as our injectable fillers to treat static facial lines (lines present at rest) or wrinkles, depressed scars, and other skin irregularities. These products are also effective for restoring or adding volume to the lips and other facial areas. These are minimally invasive procedures performed during an office visit under dental block anesthesia. The choice of the appropriate filler to satisfy a patients needs is made after a consultation and examination of the patients area(s) of concern.
Ears can be misshapen or malpositioined. The most common defect being
fly away ears or protruding ears. This is corrected by an otoplasty
operation.
Autologous Fat Transplantation/Transfer – This soft augmentaion tissue technique is ideal for restoring facial volume in patients who have adequate donor fat. Fat is harvested using manual liposuction from the lower part of the body: the abdomen, hips, or thighs, and then processed. It is placed into small syringes and used as an injectable filling material. The beauty of fat transfer is that it is your own tissue (autologous); it is viable, properly harvested and transplanted and acts like a graft, resulting in permanent or long lasting augmentation without the use of a foreign substance. Fat transplantation often accompanies other surgical procedures of the face, but can be performed as an isolated therapy under local anesthesia with intravenous sedation in our office based surgical suite.
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