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Radically Solve Concerns of Facial Contour - Cheek Augmentation or Bone Reduction?

Seeking facial perfection is an endless dream for many females. However, large amount of money are frequently wasted for repeat surgeries with disappointing results, especially if the issues with facial bone structure are not accurately diagnosed. With regard to the various cases, the author has deliberately analyzed the facial contour and tissues. Therefore, readers can select their enhancement approach with brief understanding on their own issues.

There are several distinctive facial features in our general public: high cheekbone, wide mandibular contour and protruding mouth. These characteristics of Southern Asians frequently underline the depressed temples (also known as “spouse palace” as in physiognomy) and cheek. Most people with inherited round faces may experience changes in their face shapes due to ageing, losing weight, stress or unhealthy lifestyle. In most cases, these people never gain back their weights anymore. Our unique facial features are different from the general Korean or Northern Asians with big faces. Most aesthetic surgeons will suggest their patients to treat this issue with cheek augmentation from autologous fat transfer. However, is this temporary solution an ultimate choice?

On the other hand, the facial structure mainly constructs of skeletons layered by skin, muscle and fat. If the upper skin layer lost its thickness, the skeleton beneath will protrude like a cloth hanger leading to prominent cheekbones. Due to the traditional belief on reduction malarplasty surgery, most patients will choose the easy approach with autologous fat injections (or hyaluronic acid injections) to fill the depressed area. However, these surgeries are related to various issues:

1. Due to the high adsorption rate of autologous fat, repeat surgeries are required.
2. Problems such as unevenness or lumps may occur from fat transfer.
3. At the area of fat transfer, excessive weight may accelerate the drooping of skin.
4. It is often difficult to manage the aesthetic results after the fat transfer.

Most patients can understand the first three possible outcomes, but it is frequently the fourth point which leads to other more concerning effects. Aesthetic surgeons are often in a predicament as the outcome is opposing to the original intention of becoming prettier. In order to avoid unnecessary expenses and surgeries, the author has listed the following few conditions in candidates whom should consider for reduction malarplasty surgery:

1.	Person with inherited overgrowth of zygoma, inherited overgrowth of mandibular, or large cranium.
2.	Typical square face.
3.	Person who had unsatisfying results after undergoing two or more cheek augmentations.
4.	Person whose autologous fat are completely absorbed or has absorption rate of over 50%.

Fat transfer is suitable for patients with long face shape or non-skeletal cheek depression. Although fine result can be achieved with appropriate application, results of “Korea’s facial contouring reduction” have been more convincing in enhancing upper skeletal depression (temples) and lower cheek depression. According to the author’s experience, degree of satisfaction is as high as 90%. By examining the fundamental cause, it is discovered that depressed facial area filled by reduction malarplasty will lead to a more pleasant and perfect face. Besides, improvement is seen in many cases with protruding mouth because the re-contouring of facial skin after reduction malarplasty. Therefore, it is a self-investment with several gains which cannot be achieved by merely cheek augmentation from autologous fat transfer. Moreover, advancement of bone reduction surgery and application of endoscope in recent years have eliminated the possible complications or damage to nerves in conventional surgeries. Therefore, surgeries nowadays are extremely safe and error-free. Even the drooping skin caused by traditional bone reduction can be solved by mid-face endotine with endoscope (further explanation is provided in the next issue). Therefore, middle-aged patients can enjoy satisfaction from facial re-contouring just like any young person now. Nevertheless, bone reduction is a highly complicated plastic surgery. Besides the various necessary pre-operative tests, consumers have to depend on the abundant experience and accurate diagnosis of professional aesthetic surgeons, hence avoiding unnecessary surgeries and achieve their dream results.

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