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Achieving Facial Balance
A beautiful face can take all shapes, sizes and forms, and
balance can be dramatically different in each individual
patient. Facial balance is one of the primary goals of
cosmetic surgery. The components of facial balance include
symmetry, proportion, size and shape. The focus should not
be on the individual parts of the face, but on the face as a
whole.
Profile Surgery
Although we are more concerned with our frontal view, an
attractive profile adds to our overall facial aesthetic. A
sloping forehead, protruding eyes, a flattened nose, a
prominent mouth and a weak chin can all contribute to an
unappealing profile and unbalanced frontal view. Dr. Edmund
Kwan has discovered that many, if not all of these features
can be corrected with relative ease using specialized facial
implants.
Forehead
A smooth and well-shaped forehead is an important element in
an attractive face. By using synthetic bone cement, a
material used in reconstructive surgery, the forehead shape
can noticeably improve. The synthetic bone is molded in the
area of deficiency and the resulting contour gives a softer
and aesthetically pleasing forehead shape.
Nose
The enhancement of the nose is an essential part of a
pleasing profile. The height of the nose must be in the
right proportion to the rest of the face. By raising the
height of the nasal bridge, the prominence of the nose can
be balanced.
Mid Face
A sunken Mid Face (area below the cheek bone) is more common
among Asian patients. The Mid Face bone may not project
enough in comparison to the lower facial area resulting in a
flattened face with protruding a mouth. By using a
specialized facial implant, the profile can be distinctly
improved and provide dramatic results.
Chin
A relationship exists between the nose and the chin. The
chin defines the strength of the lower face. A weak chin can
cause an over-projecting nose and having a chin implant will
augment this area. A variety of different sizes and shapes
can be used to reach the right balance.
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The Eyelid (Blepharoplasty)
Eyelid surgery is a procedure to remove fat, excess skin and
muscle from the upper and lower eyelids. Eyelid surgery can
correct the features that make a patient look older and more
tired than they feel such as drooping upper eyelids and
puffy bags under the eyes. As the skin ages, the upper
eyelid can accumulate excess skin and fat.
An eyelid lift is achieved by removing excess and wrinkled
skin. The overhanging skin is removed and the eyelid
brightens. Usually fat is removed from the lower eyelid area
along with loose skin, and no visible scar is seen. Some
patients may have a hollowed appearance of their eyes due to
a sunken upper eyelid. The injection of a small amount of
fat into this area can restore a youthful look. Similarly,
lower eyelid skin is removed if wrinkles are prominent.
Patients often request upper eyelid surgery thinking that is
where the problem lies. However, patients may actually have
a sagging brow and may be a better candidate for a
brow lift.
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Nose Surgery (Rhinoplasty)
Nose surgery reshapes the nose. It is one of the most common
plastic surgery procedures.
Nose surgery can be performed for cosmetic reasons such as
reducing or increasing the size, removing a hump, changing
the shape of the tip or bridge, narrowing the span of
nostrils or changing the angle between the nose and the
upper lip. It may also be performed for reconstructive
purposes such as correcting birth defects or breathing
problems.
There are many different variations of nose shape and size.
It is important to identify the right operation prior to the
surgery. Sometimes patients desire a certain type of nose
that may not match their facial shape. During the
consultation process, the goal of surgery should be clearly
discussed.
Non Surgical Nose Job
A non-surgical nose job offers a new alternative to traditional rhinoplasty. Using injectable gels, the nose is shaped and contoured to achieve the desired look. By making injections into precise areas of the nose the procedure can disguise a nasal bump or indentation, straighten or lift the nasal tip and increase the appearance of a flattened nasal bridge. The procedure is completed in under 20 minutes and requires no recovery time. Results can last up to two years.
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Facial Implants
Some patients may lack projecting bone in certain areas of
the face, causing the facial balance to be disturbed. Facial
implants are safe, reliable and produce consistent results.
A variety of facial implants are available for usage on the
face. These implants are usually inserted through very
inconspicuous incisions, which are well hidden.
Cheek
Cheek implants can accentuate the cheekbones and better
define the facial shape. Sometimes cheek implants are used
to enhance facelift results. There are several shapes and
multiple sizes available for usage.
Jaw Angle
Jaw angle implants are inserted through an incision in the
mouth. Usually these implants are used in male patients who
wish to have a stronger jaw-line. These implants are placed
on top of the bone and are well hidden under the jaw muscle.
Tear Trough
Hollowness under the eyes can cause a tired appearance. This
can be corrected with tear trough implants. The tear trough
is the area below the lower lid and just above the cheeks.
This groove is created where the lower lid muscle meets the
nasal muscle.
Chin
The chin and the nose share a close relationship and a weak
chin can greatly contribute to a disproportioned face. If
the chin is lacking projection, the nose will appear
dominant. Chin implants can add more definition to the lower
part of the face resulting in a dramatic change. Different
shapes and sizes are available to fit the patient’s desired
outcome.
Facelift/Neck Lift (Rhytidectomy)
As the face ages, the skin becomes wrinkled, loose and sags
as a result of the affects of the environment, gravity and
sun exposure. Facelift surgery can improve the most visible
signs of aging by removing excess fat, tightening the
muscles and redraping the skin on the face and neck.
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Brow Lift
A brow lift procedure can correct drooping brows and improve
lines and creases on the forehead. The result is a more
youthful and refreshed look. Often times, patients who
request eyelid surgery may actually be a better candidate
for brow lift surgery. This is because sagging eyebrows can
crowd the upper eyelid area. A brow lift procedure involves
removing excess tissue and redraping the skin to smooth the
forehead, minimize frown lines and lift the upper eyelids.
Brow lifts are most commonly performed on older patients to
minimize the effects of aging, but it may also be
appropriate for younger patients with droopy brows or
creases above the nose.
Ear Surgery (otoplasty)
Ear surgery is a surgical procedure that can change the size
and shape of the ears or to set prominent ears back, closer
to the head. This procedure is commonly done on children but
can also be performed on adults as well.
Jawbone Reduction
The size of the jawbone determines the width of the lower
face. If the bone is thick and wide or the muscle is thick
and bulky, it will result in a widened face. This can often
cause some patients to become very self-conscious and try to
camouflage the lower face with their hair.
To reduce the size of the jaw line, the bone is filed down
and a portion of the muscle is removed. The muscle will
still function properly but the fullness will be reduced.
This will create a more oval shaped jaw line with a softer
and smoother angle. Botox can also be used to provide a more
temporary result. An adequate dose of Botox can be injected
into the jaw muscle shrinking the size of the jaw line for
approximately 6 months.
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Facial Fractures
Nose
The nose is the most commonly broken bone on the face as it
can be easily broken from any frontal impact such as a fist,
car accident or a slip and fall. Many nasal fractures do not
require correction. However, if the nose is crooked or
breathing problems result from the injury, surgery may be
required. If the injury is less than 2 to 3 weeks old a
simple reduction with a small amount of anesthesia will
provide good results. If a breathing problem develops
following the nasal trauma then repair to the deviated
septum may be required.
Cheek Bone (Zygoma)
The cheek bone is the second most common broken bone on the
face. This usually arises from a direct blow to the cheek
bone. If the cheek bone is broken but not displaced, then no
surgery may be needed. However, if the cheek bone is
depressed or displaced, then reduction and plating may be
required. Cheek bone surgery is relatively uncomplicated if
performed within the first several weeks following the
injury.
Eye Area (Orbit)
Trauma to the eye area may result on an orbital fracture.
This type of fracture can be missed during a routine
physical examination or emergency room visit and may only be
identified with a CAT scan. Repair of this fracture can be
done with an incision to the inside of the eyelid which
leaves no visible scar. Not all orbital fractures require
surgery.
Mid Face (Leforte fracture)
A Mid Face fracture usually occurs from a severe impact to
the middle portion of the face. This type of injury can
cause malocclusion, the misalignment of teeth. Malocclusion
can be surgically repaired using plates and screws. The jaw
should also be wired to keep the proper teeth position
aligned.
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