Facial Bone Contouring
Q: Dr. Eppley, I’ve read a lot of your responses on RealSelf, as well as sifted heavily through your blog and website. I appreciate you taking the time to read about my situation.
I am Chinese and as I grew into a teen I started noticing that my facial structure is very asymmetrical. My chin is in the centre however, the angle of my jawbone is different on both sides. Though not severe, it is still quite noticeable. My cheekbone on one side protrudes more than the other..
I understand that you are well aware of the aesthetic desires of most east asian cultures – by that, I mean the v-shaped chin and jaw line, as well as a slim malar area. My question to you are:
1). is it feasible to have facial bone contouring surgery on just one side of my face so that my features can become symmetrical?
2. As I am still quite young and my skin elasticity is quite good, would my “excess” soft tissues and skin around the cheekbone area and the jawbone area also “shrink” in size to stick to the reduced bone structure?
Many patients on RealSelf or those who have undergone malarplasty seem to come to you for advice regarding their ‘sagging’ of tissue on your website. I am definitely not keen on having one side of my face extra saggy.
3. Do you employ the same techniques as those in China and Korea? How can I avoid sagging like a bulldog and getting a double chin with these procedures?
A: In answer to your facial bone contouring questions:
1) It is possible to do facial bone contouring on one side on the face if that is indicated, I do it all the time. A 3D CT scan would provide a good diagnostic evaluation of your facial structure to best answer that question.
2) Generally younger patients do better with soft tissue contraction around reduced facial bones. But there are limits at any age of how much bone can be reduced and successful tissue contraction around it to occur.
3) The bone techniques used (osteotomies) for facial bone reductions are not unique to any country as there are only so many ways to do any surgery. What is likely unique is the individual approach taken for each patient and the balance struck between the amount of facial bone reduction done vs the soft tissue risks of sagging vs the patient’s aesthetic goals. Having expanded my experience with some training in China they tend to be very aggressive because many of their patients do have really big cheekbones and jaws. But not every Asian patients does so the exact same operation for everyone will have some slightly different aesthetic outcomes. (e.g., soft tissue sagging)
Dr. Barry Eppley