Facial bones and the facial skeleton create the foundation for your facial esthetics. The harmony and balance between the facial bones will define the overall facial proportions and beauty. The face is divided in equal thirds. These facial thirds can be large or small, but they should be equal in height. A short lower third is suggestive of an underdeveloped chin or lower jaw. Measurement of the facial thirds is one means to determine the causes of facial disharmony. An assembly of various analyses of the face, including x-rays, will lay the foundation for analysis in anticipation of orthognathic surgery.

My nose is too big… or is it?

The most common overlooked bony discrepancy is the size of the chin. Often individuals believe their nose is too big or unattractive. Sometimes that is true and can be easily corrected with Rhinoplasty. Not infrequently, the problem is not the nose, but that the chin is too small. Sometimes the nose is too big and the chin is too small. The nose and chin correlation is closely bound and requires close attention. In order to restore the proper projection of the chin relative to the face and nose, a Genioplasty procedure is performed. When the chin appears small or retruded, augmentation is performed either with an implant or by sliding the chin forward. If the chin is too big, sliding it back a few millimeters will restore balance.

Jaw Line

The use of implants in the face is common practice. Some areas, however, are not readily identified by the patient as they are mostly noticed in profile. The patient may realize something is not right, but can not specify what it is. An example of such a discrepancy is the jaw angle. In younger individuals the jaw angle can be ill defined and can therefore be restored with Mandible Angle Augmentation. The jaw angle can also seem ill defined after a face lift. The lack of jaw angle definition diminishes from the jaw line and gives the appearance of age. Mandible angle augmentation with or without chin augmentation can restore a youthful jaw line.

Another overlooked discrepancy is the pyriform region. The pyriform region is an area of depression just lateral to the nostrils. This area is called the pyriform recess. With age, the loss of tissue in that area can amplify a deficiency and create a sunken appearance in an area of direct sight. The patient will rarely identify the direct cause and will most often complain of prominent nasolabial folds. Pyriform Augmentation will fill the pyriform recess and thereby rejuvenate the perioral region.

Restylane® will do too

In most cases, injecting a tissue filler such as Restylane® into the nasolabial folds and even in the pyriform area will rejuvenate this area well. In severe cases, the use of these fillers is not cost effective and Autologous Fat Transfer is used instead. Autologous fat transfer is favored by some as it is considered more natural and without any foreign substances. It also permits me to inject the fat in a broader area where it is needed.

The ultimate in balance and proportion

Orthognathic Surgery is a complex surgical approach that may be necessary for some individuals. The main objective of orthognathic surgery is to restore the facial bone harmony and balance to a normal position and proportion relative to the skull. Planning an orthognathic surgical procedure can take up to a year, and the procedure can require several hours of surgery; therefore, it is not suitable for everyone. Orthognathic surgery should be reserved for the most severe cases. The inherently meticulous analysis methods used in orthognathic surgery can be applied to determine smaller discrepancies that may be addressed by many of the common cosmetic facial bones procedures.