Last updated date: 16-Jun-2023

Originally Written in English

Revision Facial Contouring


    Facial contouring, also known as facial sculpting, is a technique that reshapes the face to enhance or improve facial characteristics while also reducing the effect of aging. To enhance the facial contour and profile, changes are done to either the soft tissues or the skeletal structure. Women, for example, may want a more tapered, youthful, V-shaped face contour. For a more manly appearance, men may choose a more pronounced and sculpted jawline.


    Why Facial Contouring is done?

    Revision Facial Contouring

    Healthy people who want to improve the shape or contour of particular portions of their face might benefit from facial contouring. The procedure's frequent objective among female patients is to soften and femininize the face features. Male patients, on the other hand, often aim to acquire a more chiseled and manly appearance.

    As a result, the surgery is frequently used as part of gender reassignment treatments. It is also good for people who have drooping facial skin, which is caused by aging and causes a person's face to lose its natural shape.

    Individuals with the following characteristics, in particular, can benefit from the procedure:


    How is Facial Contouring Surgery done?

    face contouring operation

    A face contouring operation is carried out while the patient is sedated. Prior to the operation, the patient is subjected to CT imaging scans to gather pictures of the face's bones and soft tissues. This serves as a guidance for the surgeon when doing the procedure.

    A face contouring operation normally takes time since it involves multiple alterations to create a proportional appearance. In most situations, the operation focuses on the nose, cheekbones, forehead, cheeks, or lips. As a result, there is no universal approach or procedure for face shaping. Rather, each surgery is tailored to the individual's demands and may include a variety of several cosmetic surgical methods, such as:

    The majority of incisions are performed inside the mouth or between the gums and the mucosa of the cheeks. This allows the surgeon to access most of the face, including the jawbone, while concealing the subsequent scar.

    Depending on how much work needs to be done, the procedure might take anywhere from 2.5 to 5 hours. Hospitalization, which can last anywhere from a few hours to a few days, is usually necessary to closely monitor the patient. If non-absorbable sutures are used, patients must return in two weeks to have them removed.

    Most patients recover completely within three months, with most of the edema gone within a month. However, the entire effect may not be noticed for up to a year.


    What is Revision Facial Contouring?

    Revision Facial Contouring

    If the first surgery caused problems such as asymmetry on one's face, uneven facial lines, or even health problems, revision surgery is highly recommended. After a comprehensive evaluation, the most crucial process is to determine the causes for the necessity for revision surgery. After the operation, which will be performed after a thorough consultation, satisfactory outcomes can be expected.

    Unsatisfied surgical results or functional abnormalities necessitate revision of facial bone contouring. A facility with expert revision surgery know-how should be picked for revision surgery to improve both functional and cosmetic components. When considering revision surgery, it is critical to select the appropriate approach following a comprehensive consultation.


    Why people need Facial Contouring Revision surgery?

    Facial Contouring Revision surgery

    Facial contouring revision surgery achieves the desired facial shape following the initial procedure. Because there are several reasons for face contouring revision surgery, surgical approaches differ.

    If the patient still desires a smaller face, if there is asymmetry, or if there is an extra angle after the first operation, facial contouring revision surgery is performed. Asymmetry, cheek drooping, discomfort, or poor aesthetic result are among reasons for secondary cheekbone reduction. Doctors must make exact diagnoses in order to deliver satisfactory face contouring revision surgery. To produce satisfactory revision outcomes, it is critical to determine what went wrong during the first procedure.

    A careful consultation with a board-certified plastic surgeon is required before undergoing facial contouring revision surgery. It is critical to find an expert doctor who is capable of resolving your issue.


    Square Jaw Reduction Revision Surgery

    Square jaw reduction

    A plastic surgeon performs square jaw reduction surgery (part of V-line surgery), also known as mandibuloplasty or mandible reduction, to permanently modify the shape of the lower jaw. This procedure is typically performed to achieve a smaller jaw shape, a more curved jaw, and a smoother jawline. Because this surgery is performed on the bottom half of the face, there are numerous nerve endings and blood arteries in that region.

    The purpose of "V-line surgery" or "V-lining" is to slim the face and produce a balanced V-line. Your desires and what is safely achievable define the amount of reduction you may obtain. It may be determined in the clinic using a CT scan and computer analysis. A smoother or V-shaped jawline may make a person appear smaller, younger, more symmetrical, and softer.


    How is Jaw reduction done?

    When having mandible jaw reduction, two types of cuts are possible. The first is known as the shortcut, and it runs from the rear of the jaw bone to the center of the jaw bone. The surgeon makes an incision from the inside of the mouth, designs on the bone, and then uses a portable cutting instrument to produce a diagonal cut and remove the calculated quantity needed. If necessary, the jaw might be polished and sculpted. There are no pins or plates required. The region is then sutured by the doctor.

    The Long Cut is the other type of cut. This is a line that runs from the rear of the jaw bone to the front of the chin. It enables the chin to be sculpted and decreased on the sides. Patients who have this type of haircut typically have an uneven, wide chin that does not fit the rest of their face and will not complement the new appearance they want. Sutures will be used to seal the incision once the surplus bone material has been removed and smoothed. There are no plates or screws required.


    Patient care

    • The plastic surgeon will or has already examined your bone structure and nerve endings with x-rays, CT scans, and digital imaging scans. The greatest amount of bone that can be removed will be determined by their study. You may then alter the quantity based on your requirements and desires.
    • You will go through detailed paperwork outlining your procedure(s) and sign a series of documents describing the whole process.
    • You will be brought to the surgical floor and prepared for surgery after you are ready and have used the restroom one final time before operation.
    • Because this treatment needs general anesthesia, you will be monitored by an anesthesiologist during the operation. You will fall asleep, and the procedure will begin. You will not feel any pain throughout the operation since you are sleeping. 
    • You will be awakened from anesthesia and sent to a recovery room. You will normally be supervised by nurses while staying there overnight. This is often an inpatient surgery. It is strongly advised to remain at the clinic for one night after the surgery.
    • You will need to return to the hospital for regular checks. You may have a drain inserted to assist collect extra blood. Depending on your situation, this is normally connected for 2-4 days.


    Revision Cheekbone Reduction

    Revision cheekbone reduction

    A zygoma reduction plasty, also known as cheekbone reduction surgery, is a cosmetic surgery treatment that is used to reduce the size and appearance of the zygomatic bones. The zygomatic bones support the zygomatic arch, define the cheeks, and contribute to the midface features. It should be noted that a Zygoma Reduction Plasty does not treat cheek issues caused by excessively big buccal fat pads (cheek soft tissue fat pads), which would be best addressed with a Buccal Fat Pad Removal cosmetic surgery.

    The following are some of the reasons for inadequate outcomes after cheekbone reduction surgery: 

    • Only ‘quick-cheekbone reduction’ was done so it still looks big from 45 degrees.
    • The reduction was not performed on the right position, so the most protruded part is not reduced.
    • The fixation was not performed well so the bone did not heal well and became asymmetrical.


    How is Cheekbone Reduction done?

    A person in generally excellent health who is unhappy with the prominence of their cheekbones is a perfect candidate for zygoma reduction plasty. Zygoma reduction surgery is not indicated for anyone under the age of 18, or for people who have big buccal fat pads that cause face fullness and would be best addressed with Buccal Fat Pad Removal cosmetic surgery.

    Zygoma reduction plasty can be performed in two ways. A bone-shaving procedure is effective for minimizing cheekbone forward projection but not for reducing face breadth. A more intrusive cheekbone osteotomy is an option for patients with more severe cheek issues.

    Zygoma reduction plasty plastic operations are great for midface contouring, facial width reduction, and cheek drooping correction. Asians commonly undergo zygoma reduction plasty or reduction malarplasty to decrease face breadth.


    Recovery after Cheekbone Reduction

    Following zygoma reduction plasty, most patients have five to seven days of acute downtime. Bruising and soreness normally go away within a week. Swelling might remain for three months or more. After one to two weeks, activities can be resumed and progressed as tolerated through consultation with the physician during plastic surgery follow-up sessions.

    Infection, swelling, pain, asymmetry, poor bone healing, changes in feeling, sagging cheeks, and the possibility for bone regrowth in the shaving technique are all possible adverse effects of zygoma reduction plasty.

    A zygoma reduction plasty produces permanent zygomatic reduction (decrease in the size of the cheekbones). The effects are visible after two to three weeks, but will continue to evolve over the next three months to their ultimate look.


    Revision Mini V-Line Surgery

    Revision Mini V Line Surgery

    Mini V-line surgery, as opposed to square jaw surgery, narrows the broad frontal chin to form a V-line. A blunt chin can be made smaller and thinner using T osteotomy, resulting in a compact and attractive facial shape with a V-line.

    A standard V-Line surgery comprises contouring the chin and decreasing the mandible (lower jaw) angles to give the lower section of the face a more feminine appearance. In situations when the mandible angles are excellent but the jaw lines do not end in a lovely point at the chin, the plastic surgeon may recommend a "Mini V-Line surgery" to narrow the frontal region of the jaws and chin only, rather than the complete jaw as is done in a typical V-Line surgery. This is definitely less intrusive and comprehensive than a traditional V-line operation, reducing downtime and even hazards involved with the procedure.

    If you have any of the following characteristics, you should think about having this surgery:

    • You do not have square jaws but have a blunt, roundish, or bulky chin.
    • You have an overtly short, long, asymmetric, or protruding chin.
    • You have previously undergone a V-Line surgery but are not happy with the result.
    • You want a V-line face but have limited time to spare for recovery and want to limit the pain and bruising.


    What are the advantages of Mini V Line Surgery?

    • Less Trauma and pain: A Mini V-Line surgery is less intrusive than a traditional V-Line surgery since it just targets the chin bone, resulting in less trauma to the patient.
    • No hospitalization: A Mini V-Line surgery is often performed as an outpatient treatment, whereas a conventional V-Line surgery requires a few of nights in the hospital.
    • Less surgery time: A Mini V-Line operation takes less time since it is less complex and intrusive than a full V-Line procedure (only 30 minutes versus several hours for a regular V-Line surgery)
    • Quicker recovery: The patient can resume a more-or-less normal routine within 2-3 days of the procedure, as compared to several weeks for a standard V-Line surgery. In a Mini V-Line procedure, bruising and swelling are also less severe and last for considerably shorter periods of time.
    • Less risk of nerve damage: Since the surgery is done on the tip of the chin, the possibility of damaging the facial nerves is minimal.
    • It is less expensive: Being less complicated and extensive, a Mini V-Line surgery would cost between USD 2,000 – 3,000, less than half of the cost of a regular V-Line surgery.


    How is Mini V Line Surgery done?

    T-osteotomy is a procedure in which a plastic surgeon performs a T-shaped incision to the frontal section of the jaw and the chin bone and then reassembles the cut bone to make the chin smaller and more delicate in appearance.

    • The T-osteotomy is conducted on the chin bone. This is done carefully to avoid damaging the nerves.
    • First, the chin bone is cut.
    • The cut-out middle piece of the bone is removed.
    • Then the 2 remaining pieces of bone on either side of the removed section of bone are brought together and are fixed in the center.
    • The sides are trimmed to avoid any protrusion of the bones and to keep the chin line smooth and aligned with the overall mandibular angles. This is how the frontal V-Line is formed.

    The surgery is performed under general anesthesia. This easy front chin surgery takes around 30 minutes. The patient can be discharged from the hospital the same day as the procedure and no stay is necessary. Stitches dissolve in about a week, although the healing process begins in a couple of days and the patient can return to work in about 2-3 days following the treatment.


    Possible side effects of Mini V-Line Surgery

    Although Mini V-Line surgery is less intrusive and complex than traditional V-Line surgery, it is still a surgical treatment with hazards. Nerve injury is possible during the procedure; however, it is considerably less likely than in a standard V-line operation. Post-operative complications such as soft tissue sagging, infection, and neurosensory loss or facial paralysis are uncommon but can occur.

    To avoid such issues, it is important to select an experienced and reputable plastic surgeon who specializes in face shaping and has prior experience with Mini V-Line surgery. It is also critical to explain the risks and expectations of the procedure openly. Because Mini V-Line surgery delivers more subtle outcomes than conventional V-Line surgery, it is critical to set reasonable goals.


    How much does Revision Facial Contouring surgery cost?

    Revision Facial Contouring surgery cost

    The surgeon should thoroughly interview the patient and undertake a physical examination that includes inspection and palpation of facial bones before to the procedure. The surgeon must evaluate the contribution of soft tissues as well as the skeletal structure to the patient's face deformity. A poor evaluation may result in the selection of a technique that does not address the desired change.

    The cost of cosmetic surgery can be difficult to calculate since it is dependent on several aspects, including the clinic's level, the doctor's expertise, the intricacy of a given case, whether it is a revision case or not, and the length of the surgery.

    Having stated that, the cost of a square jaw reduction ranges from 5000 to 20000 USD. As you can see, this is a fairly broad pricing range, and in most circumstances, you will not pay more than $20.000 USD. However, 20,000 USD may be an excellent value in your instance.

    This surgery may be paired with additional procedures such as zygoma reduction, masseter muscle reduction, or genioplasty (chin reduction). It might be an alternative to get the greatest and most ideal outcomes, as well as improved face balance and symmetry.

    A zygoma reduction plasty surgery might range between $2,000 and $8,000. The cost of a zygoma reduction plasty is determined by the location, board-certified facial plastic surgeon and length and complexity of the cosmetic surgery.



    Patient selection

    Patient selection is critical for face contouring surgery because the operations can radically and permanently alter one's look. To get the greatest outcomes, the surgeon should be well-versed in all procedures, as well as their various postoperative courses, and be aware of his or her own abilities to assess and repair a patient's face.

    The surgeon must be certain that the patient sincerely desires the alteration that will result from the procedure. There are several contouring methods available. Combining multiple techniques to re-equilibrate all regions of the face is sometimes useful. These techniques should be chosen based on the patient's complaint, age, gender, and morphology.

    Facial contouring is a demanding procedure that requires a constricted and obscured perspective. Disfiguration owing to muscle adhesion or bone resorption may emerge after initial surgery, and an incompetent surgeon may cause excessive bleeding. As a result, revision surgery for face contouring needs additional skill.

    Because the bone has already been modified by the initial surgeon, revision facial contouring operations are tough for both the patient and the physician. So, what can be fixed depends on how safe it is and how much of the bone can be removed.

    Jaw reduction, chin reduction, and cheekbone reduction operations are the most commonly done revision surgeries. In the case of V-line revision surgery, revision is necessary due to insufficient bone resection or asymmetry.