Background: Faces are well known to come in a wide variety of shapes. One of the well known facial shapes is the square one. The square facial shape is created mainly by the influence of the facial bones. One has to have strong cheek and jawline bones to make such a facial shape….at least in younger and weight appropriate patients. The cheeks and their zygomatic arch extensions must match the width of a strong jawline and jaw angles to create a facial ‘box’ appearance
In women the square facial shape can be very attractive and there are numerous examples of famous women who have such a facial shape. It is undoubtably the strong jawline that adds to this attraction. But the one soft tissue feature that they all share is that there is a concavity between the cheeks and the jawline. This is caused by a relative lack of substantial fat in the subcutaneous and deeper tissue planes. In essence the face has a fairly skeletonized appearance.
The aesthetics of the square facial shape can be marred if it has an intervening convexity between the cheeks and the jawline. Such ‘fullness’ can make the square face look less attractive than if there was a convexity present.
Case Study: This 23 year-old female requested fat removal from her face to give a more contoured look. She had a square facial shape with a straight line profile between her cheeks and jawline. She was very weight appropriate for her height.
Under general anesthesia a combination of buccal lipectomies and perioral mound liposuction were done through two separate intraoral incisions. A subtotal buccal lipectomy removed 3 cm diameter fat pads. The microcannula liposuction removed just over 1cc of fat per each side.
At 6 weeks after surgery, her square facial shape shows the desired concavity between the cheeks and jawline. This can her face a more sculpted look. It really takes the combination of both facial fat sites to be removed to create the full effect over the vertical distance between the cheeks and jawline.
Highlights:
1) Thinning of the more square facial shape can be done by decreasing soft tissue volume between the convex skeletal shapes.
2) Creating a facial concavity can be done by buccal lipectomies and perioral mound liposuction.
3) Such facial thinning effects creates a subtle but noticeable facial shape improvement.
Dr. Barry Eppley
Indianapolis, Indiana