Oral and maxillofacial surgeons have long been cognizant of facial form. Changing the facial skeleton has always been regarded as one of the main focuses of our profession. Although often seen as the orthopedic (bony) surgeon of the facial region, it was a natural progression that cosmetic soft tissue (skin, fat and muscle) surgery would become part of the scope of practice of most oral and maxillofacial surgeons. In other words, face lifts (rhytidectomies), nose jobs (rhinoplasty), eye lid surgery (blepharoplasty),scar revision, dermabrasion, chemical peel and liposuction are now part of the facial esthetic surgery armamentarium that most of us possess. Other cosmetic procedures we routinely perform include repositioning of the jaws, adding or decreasing the size of the chin and/or augmenting the cheek bones.
What Is A Face Lift (rhytidectomy)?
A face lift or rhytidectomy is a procedure that is used to remove facial wrinkles and facial drooping. The procedure results in a smoother and more youthful facial appearance and is usually performed with local anesthesia and intravenous sedation (visit our topic review on ambulatory anesthesia). This is completed as day surgery and the patient will not need to spend a night in the hospital. The incisions for these procedures are hidden in the hairline to avoid scarring. This is one of the most well known and popular esthetic surgical procedures that we perform.
What Is A Nose Job (rhinoplasty)?
A nose job or rhinoplasty is simply altering the anatomy of the nose. Sometimes this is performed for the external appearance alone, but other times it is done to correct a functional abnormality such as a breathing difficulty (i.e. deviated septum). The length, width, shape and projection of the nose can all be altered. As with rhytidectomy, this procedure is performed as day surgery and the patient will not need to spend a night in the hospital. These procedures are performed either with general anesthesia or local anesthesia and intravenous sedation (visit our topic review on ambulatory anesthesia).
What Is Eyelid Surgery?
Eyelid surgery is performed for many reasons. Often a patient will desire a more youthful appearance to their eyes. A patient may complain of baggy eyelids, wrinkles, tired looking eyes, heaviness in the upper eyelids, skin hanging over the eyelid margin or an obstruction of their vision. Eyelid surgery or blepharoplasty is able to address these problems by either removing or repairing abnormalities of the skin, muscle and fat around the eyes. This surgery is performed either with local anesthesia and intravenous sedation or with local anesthesia alone (visit our topic review on ambulatory anesthesia). This is completed as day surgery and the patient will not need to spend a night in the hospital.
What Is Scar Revision, Dermabrasion and Chemical Peel?
Scar revision is a procedure to lessen the obvious presentation of a scar. Although the elimination of facial scars is impossible, camouflaging them and lessening the degree of the deformity is often easily achievable. Scar revision surgery consists of thinning the scar, breaking up the visual pattern and reorienting the scar into normal skin creases.
Dermabrasion is a procedure used to level uneven areas of face. Indications include scarring from acne, traumatic scars, sun and liver spots. The procedure consists essentially of leveling the affected areas with a small diamond wheel.
Chemical peel is a facial rejuvenation procedure (younger appearance) often done for the skin aging affects of the sun. Wrinkles and sun spots (actinic keratosis), as well as acne scarring can be removed with chemical peeling. The procedure consists of the application of certain solutions to the involved areas of the face which function by removing the superficial layers of the skin. The solutions are applied by the oral and maxillofacial surgeon and remain in place for only 1 to 2 minutes. Several applications are required over 10 to 12 weeks. Often there is only one application per week.
All the above procedures are performed either with local anesthesia and intravenous sedation or with local anesthesia alone (visit our topic review on ambulatory anesthesia). This is completed as day surgery and the patient will not need to spend a night in the hospital.
What Are Some of the Other Cosmetic Procedures?
Liposuction is the removal of unsightly fat deposits via a small suction device. The small device (straw size) enables the fat removal with minimal scarring. The area most often involved is under the chin in the upper portion of the neck. A genioplasty (chin job) is a procedure in which the projection or length of the chin is changed. This surgery is done through the mouth to avoid any noticeable scars. Malar augmentation (cheek bone surgery) is also done through the mouth and can give added height and fullness to the cheeks.
Opposite of Liposuction are a variety of ‘Injectable’ Aesthetic Enhancement options available. These include Botox® and dermal fillers such as Juvaderm®, Restylane®, and Radiesse®. You may find more information on these in our “Aesthetic Facial Enhancements” section.
Orthognathic Surgery (jaw surgery) is usually performed for functional reasons (i.e. inability to chew or speak properly, TMJ pain, severe malocclusion etc.) but can also have a cosmetic impact. This type of surgery moves the upper and/or lower jaw to a more desirable location (details about orthognathic surgery can be found by visiting or topic review on orthognathic surgery).
For more additional information on these services, please visit our companion cosmetic site.