When we talk of ‘normal’ facial appearance, we imply that there is a balance to the features of the face relating particularly to the nose, the chin and the cheek bones. If one of these features is out of proportion with the others, a face can look unusual or maybe ‘abnormal’, especially to someone who is aesthetically sensitive.
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Reshaping chins and cheeks
As it is instinctive for most of us to want to look ‘normal’, it is understandable that a person can feel self-conscious if a feature of his or her face is out of proportion; either too large or too small.
What can be done?
A jutting chin can be reduced by adjusting the position of the front of the jaw bone. This is an operation called genioplasty. The small recessive chin can be built out either by sliding the chin bone forwards or by inserting an implant onto the bone.
These procedures are carried out through a cut inside the mouth in the groove between the lower lip and the gum. Sometimes implants are inserted via incisions made in the natural crease under the chin. Minor form of recessive chin can sometimes be corrected with fat graft taken from another part of the body using liposuction technique.
Flat cheek-bones can be built out by inserting implants over the cheek bones usually through cuts that are made inside the mouth where the cheek joins the upper gum.
A commonly used implant is Medpor, which is a non-biological material made of porous polyethylene. This is safe and well-tolerated by the body. Sometimes it is necessary to use a bone graft, which can be taken from various areas, such as the crest of the hip. A fat graft alone can be used if a flat cheek is primarily due to lack of cheek fat.
These operations can sometimes be done at the same time as other facial cosmetic surgery, such as a face lift or rhinoplasty, which is an operation to reshape the nose.
What are the consequences?
If the cut is made inside the mouth, there will be no visible scar. If made on the chin, the scar should be inconspicuous as it is in the natural skin crease. There is always some swelling and sometimes bruising which should settle within two to three weeks.
Temporary numbness of the lower lip and chin is common after genioplasty. Cheek implants can also cause numbness of the cheeks, the upper lip and the side of the nose. Usually this disappears within a few days though you may have a period of pins-and-needles and discomfort during recovery.
Rarely complications such as infection - leading to implant loss, permanent numbness or implant visibility under the skin - can happen.
What are the limitations?
It is usually possible to harmonise the facial features with one or more of these operations. However, as the outcome of treatment must be an appearance with which you feel happy, it is essential that you have a clear idea in your mind about what is wrong with your present appearance and that you can explain this to your surgeon.
Your Westbourne Centre surgeon will be able to give an experienced personal opinion about the changes that could be made for the better but, in the end, it is your face and how you see it that is important.
What you should do after the operation?
The most important thing to do is to treat your face gently and avoid disturbing an implant by feeling it or, worse still, trying to feel if it will move. Don’t rest your chin on your hand. Keep your mouth clean and have a mouthwash after meals whilst your stitches are dissolving. When brushing your teeth, you should take care not to damage your scars with the toothbrush. You will need at least a week off work.
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