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One form of facial reshaping is reduction for a slimmer, narrow or overall smaller face. Reductive facial reshaping procedures include bony operations such as cheek and jaw reduction. While these bony reductions are done intraorally, their effects are ultimately going to be seen based on how well the soft tissues shrink around the smaller bone support. While most of these facial reductions are done in young patients, who have the best ability for their soft tissues to shrink, this does not always occur as well as some patients would like. Various forms of facelift surgery 

Performing facial reduction surgeries in older patients is very uncommon here in the U.S. but in Asian countries this is not so rare. If young people can suffer soft tissue laxity when undergoing facial bone reductions you can only imagine how that undesired effect would be magnified in older patients. Thus combining a facelift with facial bone reductions would be a logical combination to offset the risk of soft tissue laxity afterwards.  

Int the November/December 2021 issue of the Journal of Craniofacial Surgery, an article was published on this topic entitled ‘Facial Contouring Surgery Using Facelift Approach’. The authors discussed their experience in treating Asian female facelift patients with concurrent facial bone reduction surgery. Over a four year period twenty-one (21) women had combined facelifts with cheek bone and jawline reductions. Their results were all considered successful by photographic assessment using a global aesthetic improvement scale. No long term serious complications occurred in any of the patients. Although short term complications associated with the facial bone reductions did occur.

The combination of facial soft tissue tightening and facial bone reductions is a logical one in Asian patients who have naturally wider cheeks and larger/more prominent jaw angles. From a completely different ethnic perspective Caucasian women may have facelift surgery combined with bone augmentations of the cheeks, chin and jawline which is done routinely. So the reverse should be equally true. But there is a big difference between placing implants for augmentation and removing/shifting bone for a reductive effect, certainly in terms of potential complications. But this study does demonstrate that there is no medical or technical reasons why any form of deeper facial bone reductions can not be performed with a more superficial soft tissue procedure like a facelift.

Dr. Barry Eppley

Indianapolis, Indiana

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