Definition & Overview
Facial contouring, also known as facial sculpting, is an elective cosmetic surgical procedure that improves the general appearance of the face. It is an emerging trend in some countries and its goals are to improve the proportion of the face and all facial features, as well as make the face generally smaller. It can make a person’s facial features look more balanced as well as improve facial outline.
Who Should Undergo and Expected Results
Facial contouring can be taken advantage of healthy adults who desire to improve the outline or contour of certain areas of their face. Among female patients, the common goal of the procedure is to make the contours of the face softer and more feminine. Meanwhile, male patients typically want to achieve a more chiselled look and a more masculine appearance. For this reason, the procedure is commonly a part of gender reassignment procedures. It is also beneficial for those who suffer from sagging facial skin, mostly due to ageing, that causes a person’s face to lose its original contour.
Specifically, individuals with the following features can take advantage of the procedure:
- Square jaw
- Receding chin
- Protruding cheeks
- Protruding mouth
- Protruding chin
- Asymmetrical mouth
How is the Procedure Performed?
A facial contouring surgery is performed while the patient is under general anaesthesia. Prior to the procedure, the patient undergoes CT imaging scans to obtain images of the bones and soft tissues of the face. This serves as the surgeon’s guide while performing the surgery.
A facial contouring surgery typically takes time, as it usually requires several changes to achieve a proportionate look. In the majority of cases, the procedure revolves around the nose, cheekbones, forehead, cheeks, or the lips. Due to this, there is no standard technique or procedure in facial contouring. Rather, each procedure is customised to fit the needs of the individual and may involve a combination of different cosmetic surgical techniques, such as:
- Facial implants
- Graft and tissue transfers
- Fat removal
- Bone trimming
- Chin implants or jaw line contouring
- Reduction malarplasty
- Mandibular angleplasty
- Chin advancing surgery
- Facial liposuction
- Blepharoplasty or eyelid lift
- Submental lipectomy or neck lift
- Brow lift
- Earlobe repair
- Ear pinning
- Jaw bone reduction
- V-line surgery
- Double jaw surgery
- Scalp advancement
- Rhinoplasty or nose reshaping
Most incisions are made inside the mouth or between the gum and cheek mucosa. This gives the surgeon access to most parts of the face, such as the jawbone, while hiding the resulting scar.
The surgery can take anywhere between 2.5 hours and 5 hours, depending on how much work has to be done. Hospitalisation, which can take from one to a few days, is typically required to closely monitor the patient. If non-absorbable stitches are used, patients have to return after two weeks for their removal.
Most patients fully recover from the procedure within 3 months and with most of the swelling gone after a month. However, it may take up to 12 months before the full effect can be seen.
Possible Risks and Complications
The majority of facial contouring surgeries involve incisions, which place the patient at risk of scarring (including keloid scarring and scar tissue growth), bleeding, and infection. Infection tends to be more common among patients who undergo fat removal or implant surgery. Scar tissue, on the other hand, is a more serious risk associated with facial implants. The scar is usually formed due to an abnormal immune system response, which causes it to grow and constrict around the implant. Should this happen, the shape of the implants will change and this can negatively affect the results of the contouring procedure.
It is also normal for patients to experience swelling, bruising, and numbness, which may take some time to subside.
Patients also face the risk of allergic reactions to the anaesthetics used. These include:
- Low blood pressure
- Suppressed breathing
- Blood clot in the lungs
- Blood clot in the legs
- Heart failure
- Post-operative nausea and vomiting
These risks are heightened by the fact that the procedure takes a long time to finish. Thus, to rule out any anaesthesia-related complications, surgeons require pre-operative screening to ensure that the patient has no ongoing health issue that may be aggravated by the long anaesthesia use.
Davis AD. “Restoration of facial contour in surgery of the secondary cleft lip and palate.” American Journal of Surgery. http://www.americanjournalofsurgery.com/article/S0002-9610(44)90487-3/abstract
Terino EO. “Alloplastic facial contouring: Surgery of the fourth plane.” Aesth. Plast. Surg. 16:195-212, 1992. http://link.springer.com/article/10.1007/BF00190065#page-1
Guven E., Kuvat SV., Aydin HU., et al. “Facial contour reconstruction with temporoparietal prelaminated dermal-adipose flaps.” Journal of Cranio-Maxillofacial Surgery. 2010 July; 38(5): 374-378. http://www.jcmfs.com/article/S1010-5182(09)00191-7/abstract