Making changes to one’s face is always a big consideration that requires a good deal of thought from surgeon selection to the final choice of operation(s). While there are lots of facial procedures to consider, they can be divided into those operations that treat aging changes (skin and soft tissue sagging) and those that can change structural shape of the face. (bone and cartilage)

From a psychological standpoint, these two facial procedure categories are not the same. Reversing aging changes of the face is about making one look younger…turning back the clock so to speak. Facelifts, blepharoplasties, and browlifts, for example, aim to return one to something that is familiar…a younger you.  That is an easy decision to make for most. The desire to return to what once was is deep seated. The biggest fear in anti-aging surgery is that the operation may be overdone and look unnatural. (not like oneself)

Structural changes of the face, however, pose different psychological considerations. Rhinoplasty, facial implants, and any facial bone changes head one to something unfamiliar…a changed face and a new look. This can create much greater uncertainty because one doesn’t always know what to expect. While one may have a great desire to improve one’s appearance, there is always the trepidation that one won’t like it or it may not turn out well…and then forever be stuck with it. These concerns are magnified in that many of these procedures are often done in younger patients whose sense of self-image is less established and more fragile.

Structural facial changes are usually done in one or two areas at a time This is most commonly seen in rhinoplasty alone or rhinoplasty in combination with chin augmentation or other facial implants. Making a male’s face more masculine or defined often involves the trifecta of structural facial surgery… chin, cheek, and jaw angle implants. Derounding the face usually involves neck and buccal fat removal with a chin implant for women, men may get jaw angle implants as well.

In my Indianapolis plastic surgery practice, I have seen numerous patients over the years who have come to me because they were unhappy with the results of their structural facial surgery done elsewhere. In listening to their concerns, it has become clear that in some cases there was a fundamental misunderstanding or miscommunication about objectives. Sometimes it was the ‘wrong’ operation for their concerns. (e.g., treating submalar and lateral facial concavity with jaw angle implants) Other times, it was an operation that was over- or underdone. (e.g., too large a facial implant or a nose that didn’t have enough of a change) Most of the time, their operations were done well…but the patient’s aesthetic target was missed.

While no plastic surgery operation is an exact science, one’s objectives prior to surgery should be. The use of computer imaging is absolutely essential for structural facial surgery. This is a critical method of visual communication that often unravels the specifics of a patient’s objectives. Looking at combinations of procedures and amounts of changes can almost always avoid an unexpected outcome. While predictive computer imaging is not a guarantee of outcomes (I think of it as Photoshop plastic surgery), it does put the plastic surgeon and the patient at least on the same page.

When considering any form of facial structural surgery, it behooves the patient and the plastic surgeon to meet for several consultations. Computer imaging plays a vital role in setting the surgical plan and helping with postoperative expectations. The emotions and psychological implications that come with forever changing one’s facial appearance is a high stakes proposition that should not be taken lightly. This type of facial surgery is associated with much higher rates of patient dissatisfaction than with more commonly performed anti-aging procedures.    

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Everyone knows the phrase…’beauty is skin deep but ugly goes to the bone’.  While commonly said, this phrase is only partially correct. Beauty is also bone deep as the outward appearance of the face begins down at this foundational level. How the face looks at the outside has a lot to do with how it is shaped on the inside. Any forensic scientist can attest to it. Many have seen on TV shows how an unidentified corpse’s face is ‘rebuilt’ with clay layers on top of the skull and facial bones based on established soft tissue measurements. Like a roof on a house, the outer appearance of the face is highly influenced by the shape of the bone underneath it.

Treating facial bone problems has a long history in plastic surgery. Since World War I, when trench warfare created a large number of severe facial injuries (sticking your head up out of a trench was usually not a good idea), plastic surgeons have been rebuilding, rearranging, and enhancing facial bones. Today’s plastic surgeons pay particular attention in cosmetic surgery to how the skin, fat and muscle of the face redrapes over the bones, knowing full well its influence on the final shape. Whether it is a facelift, nose job,or making one’s face more masculine, being aware of and changing the shape of the bone can lead to a better balanced and more attractive face.

In my new book, I will take you down deep inside the face on a tour of its palpable architecture. Learn how many of the commonly known, and some less commonly known, cosmetic facial implant and bone procedures work and help make for more beautiful faces. This new ebook is available at http://www.wordclay.com.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis