Background: The round face is often characterized by soft tissues excesses and bony deficiencies. It takes a combination of both tissue issues to create a round or convex facial shape. Very often the lower jaw/chin is short or deficient and the lack of a bony projection is the linchpin to this type of facial shape. While such a facial shape may be adorable as an infant or young child, it is often not perceived so in adulthood.
When the chin is short, the debate is often between that of an implant or a sliding genioplasty. There are advantages and disadvantages to either chin augmentation method. But the round or fuller face usually has a fuller submental fad pad and attached neck muscles that are relatively short. Moving the chin forward in the round face has the advantage of stretching out the attached neck muscles and improving the shape of the neck even if liposuction or a submentoplasty are still going to be performed.
The other component of the round face is excessive fat. While removing facial fat alone rarely changes one’s facial shape entirely, it still has a valuable role in facial reshaping surgery. Facial fat removal maximally consists of addressing the three main compartments of the buccal space, perioral mound/jowls and that in the neck..
Case Study: This young female had a very round face and short chin. She had an orthodontically corrected Class II occlusal relationship.
Under general anesthesia she had a 10mm sliding genioplasty advancement combined with buccal lipectomies, perioral and neck liposuction for an overall facial reshaping effort.
The combination of bony augmentation and fat reduction can produce a diametric facial effect which leads to a significant change in one’s facial shape.
- Significant facial reshaping often requires a combination of bony augmentation and fat reduction.
- A sliding geniopslasty helps the fuller neck by stretching out attached neck muscles.
- The combination of buccal lipectomies and personal and neck liposuction are the most fat reduction that can be done in the round face.
Dr. Barry Eppley