How to know if you are a good candidate for facial contouring.

[Cheekynugz]

Can someone please tell me if I would benefit from Zygoma reduction? Or any other procedure you would suggest? At 30, I would like to have a slimmer and more defined face.


I’m planning to have rhinoplasty at Koko Plastic surgery with Dr Cho Bae Jung and submental liposuction (fox line shaping) at Atop Surgery, but was wondering if I would also benefit from facial contouring procedures.

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Hi there,
Did you end up having rhinoplasty with doctor Cho? I’m looking at Koko for rhino as well but haven’t found many reviews.

 

[smallface]

I have been getting alot of people ask me this recently so I figure Ill do a post with photos explaining in as detailed as possible. An ideal candidate for facial contouring is someone who meets the following criteria:

1) Relatively small facial bones
2) Thin tissues (thick tissues can conceal the contour of the final result)
3) Protruding facial bones (Note that there's a difference between having a big face because your facial bones are overall naturally wide, versus having a big face because your facial bones are protruding.

If you look at the first photo, the red line depicts the point in which actual facial bone protrusion is present. This should give indication of how much bone manipulation is possible. The surgeon can realistically only resect the bones within this guideline. The reason why the surgeon cannot go beyond this limitation is because doing so will damage the facial nerves and connective tissues, including the motor nerves. Damaging motor serves = you look like you have a stroke. Note the location of the facial nerves in the Diagram picture. But also note that facial nerves also run under the bone too through to the inner cheek wall.

Now for the zygoma reduction many surgeons will explain it to the patient as "pushing in" the bone. What they really mean is, resection is performed via a clean fracture which then reattaches the bone with titanium wiring, screws or patented pin (depending on the technique used). The limitaton to which the width of the zygoma can be reduced is towards the temple line.

When it comes to mandible reduction, the surgeon cannot "push" the bones inwards. That's not possible because of how lower jaw is connected to the upper jaw AND there are huge motor nerves running through that region. Bear in mind that width is only altered via bone resection IF there is protrusion. A patient with no bone protusion will only yield changes in the SHAPE of their square jaw and NOT the width. However, even if a patient has no bone protrusion at the mandible angle and has overall naturally wide facial bones like the asian lady in the picture (her face isnt actually considered big btw but I used that picture to depict facial bones which are NOT ideal for facial contouring), if width is partially due to jaw MUSCLES, then jaw botox will make a noticable improvement. Patients with bone structures like the asian lady really dont have much room to "push" the zygoma inwards, nor will they see width improvements from mandible resection, only a change in shape will be yielded. Once more, the width can be reduced via botox IF strong and large facial muscles are present.

I also edited the picture of the actress to give an idea of how much change is possible for someone who is an ideal candidate, by changing her features according to her anatomical structural guidelines. In constrast if you look at the facial structure of the asian lady, I am sure you can tell the differences and why a patient with her structure would never yield much improvement.

Another important thing to note

If you are NOT an ideal candidate, be prepared to expect premature aging. There is a reason why these procedures are seldom performed on older patients. Premature aging / sagging is dependant on the follow:

1) Does the patient have bone protusion?
2) The laxity of the patient's facial muscles/tissues. Remember, the bones are the structure holding these in place. Once this has been altered sagging will occur in both ideal and non-ideal candiates. However those who are NOT ideal candidates will experience premature aging to a greater extent
3) age of the patient as these coincides with point number 2.

Note: Premature aging / sagging is may not be noticeable soon after surgery. Some notice it a year after surgery, whilst some take longer to notice it. It just depends on the laxity of your facial muscles / tissues. I only noticed my jowels sagging well over a year after my surgery.

So at the end of the day its for the patient to have realistic expectations, and consider "IF i am not the ideal candidate, am I willing to undergo these procedures knowing my results will not be the most ideal AND I will have to deal with premature aging at some point". I personally believe if the patient is mentally prepared to have a face lift later on, then it shouldnt be much of an issue. However, note that the facelift should not be done at the same time or too soon after facial contouring. For example, Mrsking who used to be active here years ago, did her facial contouring and lifting at the same time and ended up with inaccurate results from the facelift. The ONLY form of lifting you can do at the same time ONLY works for together with the zygoma reduction. Its called a periostiem lift and it mitigates sagging which occurs post zygoma reduction. It does not address the jowels. Hence, given that, its probably best to just do a full on smas lift seperately as a the smas will address both the upper and lower face / jowels at the same time.

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What if my cheekbones are barely 1/2 an inch jutting from my temple line, is it worth getting zygoma reduction? I think I just have a wide, flat face in general.

Also, is it possible to shave zygoma and push the bone backwards to create facial depth so the face looks less flat?

And do you recommend "growing" a hairline/hair transplant near the temple area to make that part look slimmer?

Most normal people, their temple area is minimal and it's "behind" their eyes, whereas mine seems to flatten out, making my eyes look too close together because of the vast space.

 

[smallface]

I have been getting alot of people ask me this recently so I figure Ill do a post with photos explaining in as detailed as possible. An ideal candidate for facial contouring is someone who meets the following criteria:

1) Relatively small facial bones
2) Thin tissues (thick tissues can conceal the contour of the final result)
3) Protruding facial bones (Note that there's a difference between having a big face because your facial bones are overall naturally wide, versus having a big face because your facial bones are protruding.

If you look at the first photo, the red line depicts the point in which actual facial bone protrusion is present. This should give indication of how much bone manipulation is possible. The surgeon can realistically only resect the bones within this guideline. The reason why the surgeon cannot go beyond this limitation is because doing so will damage the facial nerves and connective tissues, including the motor nerves. Damaging motor serves = you look like you have a stroke. Note the location of the facial nerves in the Diagram picture. But also note that facial nerves also run under the bone too through to the inner cheek wall.

Now for the zygoma reduction many surgeons will explain it to the patient as "pushing in" the bone. What they really mean is, resection is performed via a clean fracture which then reattaches the bone with titanium wiring, screws or patented pin (depending on the technique used). The limitaton to which the width of the zygoma can be reduced is towards the temple line.

When it comes to mandible reduction, the surgeon cannot "push" the bones inwards. That's not possible because of how lower jaw is connected to the upper jaw AND there are huge motor nerves running through that region. Bear in mind that width is only altered via bone resection IF there is protrusion. A patient with no bone protusion will only yield changes in the SHAPE of their square jaw and NOT the width. However, even if a patient has no bone protrusion at the mandible angle and has overall naturally wide facial bones like the asian lady in the picture (her face isnt actually considered big btw but I used that picture to depict facial bones which are NOT ideal for facial contouring), if width is partially due to jaw MUSCLES, then jaw botox will make a noticable improvement. Patients with bone structures like the asian lady really dont have much room to "push" the zygoma inwards, nor will they see width improvements from mandible resection, only a change in shape will be yielded. Once more, the width can be reduced via botox IF strong and large facial muscles are present.

I also edited the picture of the actress to give an idea of how much change is possible for someone who is an ideal candidate, by changing her features according to her anatomical structural guidelines. In constrast if you look at the facial structure of the asian lady, I am sure you can tell the differences and why a patient with her structure would never yield much improvement.

Another important thing to note

If you are NOT an ideal candidate, be prepared to expect premature aging. There is a reason why these procedures are seldom performed on older patients. Premature aging / sagging is dependant on the follow:

1) Does the patient have bone protusion?
2) The laxity of the patient's facial muscles/tissues. Remember, the bones are the structure holding these in place. Once this has been altered sagging will occur in both ideal and non-ideal candiates. However those who are NOT ideal candidates will experience premature aging to a greater extent
3) age of the patient as these coincides with point number 2.

Note: Premature aging / sagging is may not be noticeable soon after surgery. Some notice it a year after surgery, whilst some take longer to notice it. It just depends on the laxity of your facial muscles / tissues. I only noticed my jowels sagging well over a year after my surgery.

So at the end of the day its for the patient to have realistic expectations, and consider "IF i am not the ideal candidate, am I willing to undergo these procedures knowing my results will not be the most ideal AND I will have to deal with premature aging at some point". I personally believe if the patient is mentally prepared to have a face lift later on, then it shouldnt be much of an issue. However, note that the facelift should not be done at the same time or too soon after facial contouring. For example, Mrsking who used to be active here years ago, did her facial contouring and lifting at the same time and ended up with inaccurate results from the facelift. The ONLY form of lifting you can do at the same time ONLY works for together with the zygoma reduction. Its called a periostiem lift and it mitigates sagging which occurs post zygoma reduction. It does not address the jowels. Hence, given that, its probably best to just do a full on smas lift seperately as a the smas will address both the upper and lower face / jowels at the same time.

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So my side profile is like the Korean guy, as in my big ass cheekbones eat up any side profile view you might get and there's no back or forward projection, it looks flat. What surgery can I get to make my side profile more like the girl in the 2nd pic, like it's 3D and you can see a facial outline in profile view and it's like her eyes lie forward and not lie flat - if that makes sense.

For the record, I plan to add depth to the back of my head to make it more 3D and less flat, but I also need to fix the facial flatness I have. Even if it's the most dramatic, expensive, risky surgery, I'm willing to do it.

 

[K Couture]

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So my side profile is like the Korean guy, as in my big ass cheekbones eat up any side profile view you might get and there's no back or forward projection, it looks flat. What surgery can I get to make my side profile more like the girl in the 2nd pic, like it's 3D and you can see a facial outline in profile view and it's like her eyes lie forward and not lie flat - if that makes sense.

For the record, I plan to add depth to the back of my head to make it more 3D and less flat, but I also need to fix the facial flatness I have. Even if it's the most dramatic, expensive, risky surgery, I'm willing to do it.

Nothing unfortunately can give you her bone structure. As I mentioned, facial depth cannot be changed. Back of head is different as its one simple round contour. The front of the face is not, and has many connective nerves muscles tissues fascia etc which work in harmony with each other. Its physically impossible to achieve that unfortunately. For example if you use fat graft or implants to augment the front cheeks, it will just make you look fuller, not more angular.

 

[smallface]

View attachment 5439197View attachment 5439198

So my side profile is like the Korean guy, as in my big ass cheekbones eat up any side profile view you might get and there's no back or forward projection, it looks flat. What surgery can I get to make my side profile more like the girl in the 2nd pic, like it's 3D and you can see a facial outline in profile view and it's like her eyes lie forward and not lie flat - if that makes sense.

For the record, I plan to add depth to the back of my head to make it more 3D and less flat, but I also need to fix the facial flatness I have. Even if it's the most dramatic, expensive, risky surgery, I'm willing to do it.

((((

Can I at least get a pale imitation? Not exactly is fine, but some forward projection. I've shortlisted EU Dental for my jaw + cheekbones, they told me I need an in person ct scan for them to decide what can be done.

 

[K Couture]

((((

Can I at least get a pale imitation? Not exactly is fine, but some forward projection. I've shortlisted EU Dental for my jaw + cheekbones, they told me I need an in person ct scan for them to decide what can be done.

Its really not possible. Believe me I myself have tried for years. I mean the only time you can do it to your JAW to some degree is if you have an overbite whereby the lower jaw needs to be moved forward a little. Even then there is a limitation. And if you don't have issues with your bite, doing so purely for aesthetic purposes will give you an underbite....something you really dont want lol

 

[smallface]

Its really not possible. Believe me I myself have tried for years. I mean the only time you can do it to your JAW to some degree is if you have an overbite whereby the lower jaw needs to be moved forward a little. Even then there is a limitation. And if you don't have issues with your bite, doing so purely for aesthetic purposes will give you an underbite....something you really dont want lol

I think I already have an underbite - from side profile view my jaw sticks out more than the upper 3/4 of my face and in frontal view, my jaw area is wider than the top portion making me look masculine - but also I have cheek fat padding the area. So basically, if there's any surgery to pull forward the upper 3/4 of my face (forehead, cheeks) to match the jaw projection so I don't have an inbred, recessed features look.

 

[K Couture]

If you have an underbite then that needs to corrected and moved backwards, which would shorten your face a little but give it a more balanced look. Forehead can be projected with fat graft thats simple. But as for the cheekbones for frontal face for facial depth, you don't get that defined look. Theres no way to pull those bones forward. Using implants of any sort will just make your face look fuller, not more angular or defined.

 

[smallface]

If you have an underbite then that needs to corrected and moved backwards, which would shorten your face a little but give it a more balanced look. Forehead can be projected with fat graft thats simple. But as for the cheekbones for frontal face for facial depth, you don't get that defined look. Theres no way to pull those bones forward. Using implants of any sort will just make your face look fuller, not more angular or defined.

But if my midface/front cheek area is flat, won't adding 3d printed bone implants add some type of dimension?

 

[K Couture]

But if my midface/front cheek area is flat, won't adding 3d printed bone implants add some type of dimension?

it will add volume, not dimension in terms of angular features. Because your skin and facial tissues are thick, so adding those implants willl only make it look more volumous. Secondly, angular features are the result of connectivity between the muscle, bone, facial tissues, fascia etc. Adding implants do not change this relationship. It merely augments the thick facial tissues forward, thus giving it an appearance of more volume.

 

[Solorun]

I think I already have an underbite - from side profile view my jaw sticks out more than the upper 3/4 of my face and in frontal view, my jaw area is wider than the top portion making me look masculine - but also I have cheek fat padding the area. So basically, if there's any surgery to pull forward the upper 3/4 of my face (forehead, cheeks) to match the jaw projection so I don't have an inbred, recessed features look.

Lefort 1, 2 & 3 will pull your midface forward, lefort 1 is commnly used in 2 jaw to bring the upper jaw forward

 

[smallface]

it will add volume, not dimension in terms of angular features. Because your skin and facial tissues are thick, so adding those implants willl only make it look more volumous. Secondly, angular features are the result of connectivity between the muscle, bone, facial tissues, fascia etc. Adding implants do not change this relationship. It merely augments the thick facial tissues forward, thus giving it an appearance of more volume.

Is there a way to melt fat and then remodel muscle, fascia to mimic a similar result?

 

[smallface]

Lefort 1, 2 & 3 will pull your midface forward, lefort 1 is commnly used in 2 jaw to bring the upper jaw forward

OMMMGGGGG YESSSSS, I knew there was a surgery name I was forgetting!!! I only remembered lefort, googled that and it talked about jaw augmentation so I dismissed it. Looks like lefort 3 is what I need.

I just googled before and after pics tho and it's mainly used for people with severe facial deformities....I'm hoping there's like a less drastic version of it.

Anyhow, do you have surgeon recommendations in Korea for this? Tnx

 

[Solorun]

OMMMGGGGG YESSSSS, I knew there was a surgery name I was forgetting!!! I only remembered lefort, googled that and it talked about jaw augmentation so I dismissed it. Looks like lefort 3 is what I need.

I just googled before and after pics tho and it's mainly used for people with severe facial deformities....I'm hoping there's like a less drastic version of it.

Anyhow, do you have surgeon recommendations in Korea for this? Tnx

Sorry, i dont
I think Korea is more experienced in reduction than augmentation, imo you better go to western surgeon if you want augmentation.

I think there is a less invasive version of lefort 3 called modified lefort 3, i read it performed by OMS in US who i forgot the name.

 

[Solorun]

But lefort 3 is really invasive procedure, how about you go this way:
First try to lose facial fat by diet or maybe acculift for more instant result. After that you can try filler first to augment your cheek area and if you like the result you can go with custom cheek implant. Custom implant maybe cannot give you result 100% like filler tho.