World renowned cosmetic surgeon Dr.Vijay Sharma - A specialist in Facelift,Face reconstruction, Face balancing, Double chin correction, Liquid Facelift, Facebra, Wrinkle Eraser, Chemical peeling

FACIAL CONTOURING (IMPLANTS, LIPO-SLIMMING ETC)

Nowadays, if you don't like the shape of the face that Nature gave you, a cosmetic surgeon can even improve on that. He can add fullness to areas of deficit, like receding chins, using bone, cartilage or, most conveniently, a silastic implant, which he can shape as required. On the other hand, he can also reduce areas of excess by cutting out unwanted bone, or vacuuming out fat.
Here are some of the possibilities in the intriguing field of facial contouring

CHEEK IMPLANTS

Are a popular -- and virtually instant -- solution for cheekbones that have lost their youthful prominence as the underlying muscle has sagged (or for cheekbones that are genetically flat). If a facelift is being performed, silastic implants can be inserted over the cheekbones at the same time.
The process is known as malar augmentation. The surgeon determines the appropriate size of the implant to be used in an individual case, the insertion being effected most commonly through the mouth. ( If eyelid surgery is being done at the same time, however, an incision made in the lower eyelid can be used to insert the implants).

The surgery takes about an hour. Extreme care must be taken to avoid prodding at the implant, especially during the first week. Swelling and bruising take from two to three weeks to subside, following which you can show off your new profile to the world.

CHIN IMPLANTS

Often (as mentioned in the later chapter on Nasal Surgery), some types of deformed noses are associated with `weak' or receding chins. Or, with age, soft tissues in the chin shrink, reducing volume in this facial feature. Adding volume will not only make for a more blanced and aesthetic facial profile, but also for an immediately more youthful look. Silicone chin implants can today be shaped to the required contour by the surgeon and then put in place through an incision made either inside the mouth (just inside the lower lip) or under the chin.

When a nasal deformity is accompanied by a receding chin, the chin correction should be done first. In the aging patient, a chin implant can be carried out at the same time as a face-lift.
The silicone implant is sutured in position and the stitches removed about a week after the surgery by which time the body's tissues will have meshed it into place. In the interim, you'll have to avoid prodding at the implant or trying to push it around: in the immediate post-surgery period, swelling around the chin may make it look larger than natural and may distort its new contours. The minimal bruising and swelling will last about four days, Because there are few nerve endings in this area there's hardly any pain. Antibiotics are routinely administered, post-surgery, so infection is rare; if it does take place, the implant will extrude through the site. Implants can also spontaneously shift around, which again will result in extrusion. An extruded implant -- or a badly-positioned one -- can be replaced about three months later. (Or bone can be grafted from another part of the body instead of using a silastic implant).
Most of the swelling subsides within six months. If the incision has been made under the chin, the scar fades within six months to a year.

BONE CONTOURING SURGERY

      Some facial defects, such as protruding chins, call for the surgeon to actually break the existing bone structure, cut away part of it and shift the new structure into proper position.
A jutting jaw (known as prognathism) often occurs in conjunction with the malocclusion of teeth, in which the upper teeth are not in alignment with the lower teeth. It can be present as a genetic defect or may sometimes be caused by an accident.
      One approach is to make a superficial cut at the joint in front of the ear, crack the bone and cut out a V-shaped piece of it. This causes the protruding jaw to fall in line with the rest of the face. The teeth and jaw are wired together to inhibit motion. No chewing is permitted for about six weeks during which time you'll only be allowed to sip liquids through a straw. The line of fine stitches in front of the ears fades away with time.
      If you don't like the overall shape of your face, a surgeon can improve that, too. He will make an incision running from one ear to the other, across the top of your skull. He will then separate the facial skin from the underlying bone, and proceed to cut these bones across the brow, down along your temples and all the way to the back of your upper jaw. Once he has detached the upper part of your facial bones from the rest, he can move them around to create a new face. If he needs to add on new bits of bone, he can use grafts taken from, say, your hips. Once your bones have been wired into the new shape, your skin is sutured in place, too.
      Sounds like something you'd want to do, only if you were on the run (from your girl- friend?) Nevertheless, it's possible!

LIPO-SLIMMING FOR THE FACE

       "Fat-suction surgery", (in common use now) to vacuum out stubborn fat from love handles, thunder thighs and over-large buttocks, can also be used to remodel the contours of your face -- revealing cheekbones, eliminating extra chins, slimming jowls. This is because advances in this technique have made possible the kind of precision required to suction within the narrower confines of these areas.
      One of these advances is the miniaturized cannula (the tool that suctions out the fat) -- it's so small that 20 could fit in an inch. The other advance is improved knowledge about the optimum amount of fat that should be removed. Compared to the thighs, (where the fat layer lies about an inch thick,) on the face and the neck the fat is relatively thin -- about a quarter of an inch in the cheek, for instance. This leaves the surgeon with more narrow margins to work within: over-correction by one-sixteenth of an inch could leave irremediable grooving.
      Despite these advances, not every case of face or neck fullness lends itself to "lipo-slimming". If the doctor can't take a "cheek pinch" of about two-thirds of an inch, the roundness in that area is probably not due to fat but to underlying bone and muscle. A similar pinch test must be done for the neck-the patient grimacing and clenching his neck muscles to make the fat layer stand out.
Again, the elasticity of the skin -- an important consideration in any type of liposuction -- is even more critical when determining the suitability of the face or neck area for such treatment. Skin that is lax or sun-damaged simply can't snap back tautly enough over a fat-suctioned face or neck. Ideal candidates, skin-wise, are those who are under 35, or who have made sun-protection a lifetime habit.
      In suitable patients, the incisions made are also tiny, so miniaturized that they need, at most, a micro stitch with hairline thread. The cannula is inserted at specific sites: just under the ears and the chin and alongside the nostrils.
      The surgery can be done on a day-care basis, though you might not be able to return immediately to work -- or to play -- because, though there is little bruising on the face and neck compared to other liposuction sites, there is noticeable swelling. However, within about a fortnight, all signs of the surgery will have vanished, leaving you with only sleeker, more defined contours.