Facial cosmetic surgery continues to grow in popu- larity. It focuses on improving our facial appear- ance. Many patients seek treatment to reverse changes that occur with aging, such as loose skin, decreased tissue volume around the face and neck, fine lines, sagging jowls, and double chin. Oral and maxillofacial surgeons are specialized in perform- ing a variety of surgical and non-surgical cosmetic procedures to improve your facial appearance.1 Common surgical procedures include rhinoplasty (nose surgery), rhytidectomy (facelift), blepharo- plasty (eyelid surgery), browlift (forehead lift), gen- ioplasty (chin augmentation), otoplasty (ear repositioning), and liposuction. Common non-surgi- cal procedures include: skin resurfacing, neuromo- dulators, and dermal fillers.

Surgical Procedures

1) RHINOPLASTY (NOSE SURGERY)

Nose surgery is the most commonly performed and most difficult facial cosmetic procedure. It is per- formed to correct nasal disease, to improve unsatisfac- tory esthetic appearance, to reduce airway obstruction, and to reconstruct congenital defects.

2) RHYTIDECTOMY (FACELIFT)

A facelift, or rhytidectomy, is a surgical procedure that improves visible signs of aging in the face and neck, such as:  Sagging of the skin of the face and neck. Deepening of the fold lines between the nose and corner of the mouth  Jowls in the cheeks and jaw  Loose skin and excess fat of the neck that can appear as a double chin.

3) BLEPHAROPLASTY (EYELID SURGERY)

Blepharoplasty involves the removal of excessive eyelid skin and/or removal of orbital fat to treat aging- related changes in the area around the eyes.

4) BROWLIFT (FOREHEAD LIFT)

This procedure involves the removal of excess skin and the forehead skin is repositioned superiorly. The incisions are usually hidden within the hair-bearing scalp.

Nonsurgical Cosmetic Procedures

1) CHEMICAL PEELS

During a chemical peel, the agent penetrates through the superficial skin layers (epidermis and first dermal layer). The chemical agent causes the surface skin to peel off at various depths of the skin and stim- ulates more youthful looking skin regeneration. Dif- ferent agents have different depths of penetration. Agents include glycolic acid, trichloroacetic acid, and phenol.

2) DERMABRASION

Dermabrasion is another technique used to smooth scars and superficial wrinkles. This tech- nique is performed under local anesthesia and/or a freezing agent. A high-speed rotating brush, sand- paper, or an abrasive device is used to remove the top layer of the skin, allowing younger looking skin to appear.

3) LASERS

Lasers are used to correct facial wrinkles, scarring, sun-damaged skin, and other signs of aging. Laser treatments cause minimal trauma to the surrounding skin. The technology allows for precise control of the depth.

4) DERMAL FILLER

SDermal fillers are used to replace volume and recontour the aging face (Fig 1). They are also used to treat scars, facial wrinkles, and skin folds.


FIGURE 1. Places where fillers can be used to smooth the skin.

5) NEUROMODULATORS (BOTULINUM TOXIN)

Botulinum toxin injection for treatment of facial wrinkles is the most frequently performed cosmetic procedure in the United States. The agent freezes the nerves controlling tiny muscles, smoothing wrinkles. The most potent is the botulinum toxin serotype A (BoNTA), which is the one used for cosmetic treat- ments of glabellar lines and other hyperfunctional facial wrinkles. Currently there are 4 BoNTA approved by the FDA for cosmetic use. In addition to treating already developed wrinkles, BoNTA has been shown to prevent the development of wrinkles.Finally, your oral and maxillofacial surgeon can use a combination of procedures to enhance your face and reverse the aging process.