Facial Contouring (Facial Sculpting) Surgery for Asians

Looking Your Best

This is the first in a series of articles on Plastic Surgery with Dr Leow Aik Ming.

The shape and characteristic features of facial skeleton and its soft tissues are the fundamental determinants of facial appearance. A balanced proportion and symmetry of the forehead, nose, cheek, chin and jawline translate into a desirable and beautiful face. Variation in facial skeletal features, cartilaginous structures and soft tissue supports are the most important factors distinguishing people of different ethnic background. Caucasian faces tend to be longer and narrower than that of Asians. When seen in cross section, it has relatively greater anterior projection and decreased width. The Caucasian noses are typically with high nasal bridge, straight, well defined tip projection and narrower nostrils. Conversely, the Asian faces tend to be wider and shorter when observed from an anterior view. When seen in cross section, it has less anterior projection, and the transverse dimension is wider. Asian noses are generally shorter, poorly defined tip, broader nostrils and sit shallow on the face.

The facial appearance can be dramatically changed through facial contouring surgery by either augmenting the deficient areas or reducing the over prominent areas. Reduction is usually done by reducing the bony areas, cartilage or soft tissues that are prominent, whereas augmentation is done by filling in areas with one’s own tissue (bone, cartilage or fat grafts) or with implants.

The main objective in facial contouring surgery is to create an ideal facial profile and restore facial harmony that suits individual needs and ethnicity. Facial contouring surgery should not be excessively performed to attain “Caucasian beauty” which is often perceived as “ideal human beauty” but rather to maintain an ideal non-ethnic specific beauty. In other words, its aesthetic goal is to create an attractive face based on the patient’s identity that blends harmoniously and not to create attractive Caucasian features on an Asian face.

Depending upon the requirements, facial contouring surgery can be done either as a single procedure or in combination with several surgical procedures. The list of facial contouring surgical procedures that are frequently performed to change facial skeletal, cartilaginous and soft tissue structures include:

Facial Skeletal Changes: Forehead contouring surgery (feminization surgery), cheek augmentation or cheek reduction (zygoma reduction), mandible angle reduction, corrective jaw or orthognathic surgery and chin reduction or augmentation called  genioplasty.

Facial Cartilaginous Framework Changes: Rhinoplasty (reshaping nose) , alarplasty (narrowing of too-wide nostrils) and otoplasty (ear correction)

Facial Soft Tissue Changes: Blepharoplasty (eyelid surgery), canthoplasty (changing the corner of the eye position), lip augmentation or reduction, masseter muscle reduction (for jaw line), buccal fat reduction (decrease fullness in the cheeks and face) and fat grafting.

* All these procedures mentioned above will be discussed in coming issues.