Explore Plastic Surgery

Not infrequently I get requests from patients for the desire to transform a round face into a more shapelier one. One cause of a round face is that the patient is overweight. A full neck, round cheeks, and a lot of subcutaneous fat throughout the face creates a generalized fullness that creates a fat and round face. These patients know full well that they are overweight and some liposuction of the neck and buccal lipectomies may make some difference. But weight loss will probably make the most difference in these cases. And these procedures should not be performed until some weight loss has been achieved.
But the overweight patient is not what usually makes up the ’round face’ patient. Most commonly these are younger patients that are not significantly overweight and are usually closer to being more height and weight porportionate. They may have some mild fullness in the cheeks and neck but often their bony prominences (cheeks, chin, or jaw angles) may be somewhat deficient. The approach to these patients must deal with both hard and soft tissues issues to be effective at improving the face’s angularity and definition.
In addition to the fullness of the cheeks and neck, the next most important consideration in facial shape improvement should look at the chin. Often it may only be midly short in the horizontal dimension but the width of the chin is also important, particularly in the male patient. Chin implants today can provide more projection as well as width in many different sizes. Placed through a small incision under the chin bone, a chin implant can lend more definition and squareness to the lower face from subtle to dramatic results.
Upper facial fullness, more specifically midfacial fullness, can be achieved through cheek implants. Placed into position by incisions inside the mouth under the upper lip, cheek implants can provide good highlights through three-dimensional enhancement of the bone as it wraps around the area below the eye. An amazing aray of cheek and midface implants is available to provide a lot of enhancements around this important facial landmark. When paired cheek implants are combined with a chin implant, an upside down triangle of change is created that directly opposes a more round or oval facial shape.
Jaw angle implants are always a possibility but these are rarely needed in most really round faces. They can produce some lateral facial fullness but this is not usually helpful in ‘de-rounding’ the face.
The procedures of buccal lipectomies, neck and jowl liposuction, chin and cheel implants make up the usual plastic surgery tools for facial rehaping. Which one or combination of procedures is most helpful for improving facial definition is best determined by careful computer imaging study between the patient and their plastic surgeon.

Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Chin, Cheek, and Jaw Implants for Facial Augmentation in Indianapolis by Dr. Eppley

In the pursuit of improved facial balance and shape, the use of solid facial implants is a simple and proven method. While there are facial implants made from different materials that can be used, the use of solid silicone (rubber) chin, cheek, nose and jaw implants are by far the most commonly used. They are soft, flexible, and slide easily into place on top of facial bones. These type of facial implants are placed deep to the skin down at the bone level. Since they are solid, not gel-filled, there is no risk of implant leakage or breaking. All facial implants can be inserted through very discrete incisions that often leave no visible scars on the face. While any implant (foreign-body) has some risk of infection, facial implants infection is quite uncommon.

Enhancing the chin with an implant is the most commonly performed facial implant procedure. With a small incision under the chin, a chin implant can be easily put into place, bringing the chin forward so that it is in balance to the nose and lips. Unlike the old style ‘button’ chin implant, there are many different styles of chin implants today. From curved styles to a more box shape, to those chin implants with a central dimple, there are many options to custom tailor a chin implant to fit most patient’s faces. Usually the chin implant is sutured into place, a metal screw can be driven through the implant to the bone. This screw fixation method can eliminate one of the very few complications of chin implants, that of shifting or changing position after surgery causing chin asymmetry. Chin implants are commonly in conjunction with other facial procedures including rhinoplasty, neck liposuction, and facelifts.

Cheek implants also have a variety of styles, allowing fullness to be gained over the prominence of the cheekbone, filling out the hollow underneath the cheekbone, or allowing more fullness to be gained up to the side of the nose. By going through the mouth under the upper lip, there is no facial scarring. Cheek implants help bring fullness to a flat cheeks, help camouflage a prominent nose, or restore facial fat atrophy lost in HIV disease. Metal screw fixation seems to be of particular importance as the cheek implant is really sitting ‘on the side of the cliff’ so to speak and, therefore, is more prone to the risk of moving out of place after surgery.

Jaw implants of the mandibular (jaw) angle are relatively new. Jaw implants are designed to ‘square’ the face at the jaw angle for a more masculine look or to correct facial asymmetry if jaw development is different between the two sides of the face. Swelling and recovery after jaw angle implant placement is greater than with chin and cheek implants as the big chewing muscles must be lifted up to put the jaw angle implant in place. This causes some soreness in opening the mouth for several weeks after surgery.

In some cases, the use of different implants in the same patient, such as a chin and jaw angle implants in a male, can provide dramatic changes in one’s facial appearance. Facial implants are a powerful tool, that is simple and usually uncomplicated, to achieve facial enhancement.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis