Think about it. The face constitutes less than 9% of the body surface area, yet it’s the key to our identity, affects our self-esteem, governs our relationships and even advances our career. What’s in a face? Facial appearance depends upon genetic inheritance. Beauty depends on the balanced growth and development of the facial skeleton and dentition. However, environmental factors like trauma, diseases and drugs, as well as habits like thumb sucking, nail chewing etc, affect the facial structure by creating imbalances in bone development. Aesthetic facial surgery is an exciting new specialty that offers an improvement in facial contours, through corrective surgery on the facial skeleton and soft tissues.

Diagnosis of Facial Deformities

The extent of facial deformities depends on the cause:

  • Excessive growth of the upper jaw will cause protruded upper teeth and a “gummy” smile due to excessive exposure of the gums and difficulty in closing lips
  • Excessive growth of the lower jaw can result in a protruding chin
  • Deficient growth of the lower jaw means a receding chin
  • Deficient growth of the upper jaw results in a `dish face’ appearance

Is surgery a must?

The decision to operate hinges mainly on the body image concept held by the patient. In other words this is an elective surgery where a patient decides that a transformation is vital for his or her well being, in the long run. The surgery involves breaking the jaws in a preplanned manner (after studying photos, dental models and a special skull X-ray) and then repositioning them using wires and plates for better aesthetic and functional results. The operation may take anywhere between 1 to 5 hours and is invariably performed under general anesthesia, with procedures being done through the mouth itself, so that no scars are visible on the exterior. Recovery takes a few days and patients are only allowed a soft, high calorie diet and advised to avoid contact sports for a month. Complications, if any are usually loss of blood requiring transfusions, anesthetic side effects like dry cough, nausea and vomiting, and altered sensations over the lips due to tissue swelling after surgery. All these are minor and self-limiting.

End Result

Today a handsome or pretty face is worth a fortune. Facial profiles can be engineered to enhance symmetry, achieve dimples, high cheekbones or a cleft chin. More importantly, it can remove the psychological trauma of a deformity and improve function (for instance, by realigning teeth for better mastication). Good teamwork between the oral and maxillofacial surgeons, the orthodontist, radiologist and the anesthesiologist are a must to ensure a good outcome. A word of caution. Don’t have unrealistic expectations of attaining “film star” looks through aesthetic surgery. Remember a surgeon can only modify you not make you!

DR. PAUL V. JOSEPH
Oral & Maxillofacial Surgeon

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