Facial Contouring Q&A 8. How Much Do You Know About Plastic Surgery Information?

Hello. I’m Director Jo Hyun-woo of Injeong Plastic Surgery.

Last week, I held a YouTube live broadcast called ‘Ask Anything About Plastic Surgery.’

Based on the many questions asked during the live broadcast, I’ll organize them and answer them here.

Q1. If there is a lot of fat on the chin, should I lose weight first and then have contouring surgery?

A. For people with a lot of facial fat, there are cases where bone surgery does not show much externally.

If you feel that you have a lot of fat, it is best to lose weight first and then have contouring surgery.

Since the amount of bone that can be removed is limited, even if you have contouring surgery first and then lose weight, you can still get a dramatic effect.

Q2. In the case of a very slight underbite, can rotary shaving alone be effective? Or do I need osteotomy?

A. In fact, for an underbite, the best method is to push the bone back through osteotomy.

If the underbite is really very slight, some improvement is possible just by shaving the chin bone, but the thickness that can be shaved is about 2–3 mm.

If you also need to reduce the length of the chin, it should be possible to correct it sufficiently by reducing the chin length with rotary shaving and doing shaving at the same time.

It would be best to make the judgment after taking a CT scan.

Q3. Does zygoma surgery always have to be done under general anesthesia?

A. Basically, the 3D zygoma surgery we commonly know, which is done through an intraoral incision, is performed under general anesthesia.

The reason for general anesthesia is that, because the surgery is done through an intraoral incision, the inside of the mouth needs to be washed during the operation. When washing the inside of the mouth, there is a risk that the cleaning solution may go down the throat and block the airway, which can be dangerous. So for safe surgery, general anesthesia is used.

The 230-degree zygoma surgery performed at our hospital is done through a scalp incision rather than an intraoral incision, so the patient’s breathing can be sufficiently monitored under sedation anesthesia while the surgery is performed. For patients who feel a lot of burden about general anesthesia or surgery, we recommend the 230-degree zygoma surgery.

Q4. Can men’s jaws also be made slimmer with a T-osteotomy like women’s?

A. Of course, men can also have a T-osteotomy to make the chin slimmer.

Because men have a larger front chin bone, after a T-osteotomy, the middle bone can be cut more and brought together more, which can produce a more dramatic effect.

Q5. I don’t really have prominent cheekbones, but my face is wide horizontally. Should I get contouring type 2 excluding the cheekbones?

A. If, when viewed from the front, there are no protruding cheekbones and the line is smooth, there is no need for cheekbone surgery.

To improve a wide-looking face, you may be able to make the overall face slimmer through lower jaw surgery, masseter muscle reduction, or buccal fat removal.

Q6. I have asymmetry in the side cheekbones and a difference in eye height. Can this be improved with 230-degree zygoma surgery?

A. If we take CT scans of patients, there is not a single person who is not asymmetrical.

230-degree zygoma surgery is not a surgery that cuts and repositions the cheekbones; rather, it pushes in the side cheekbones and uses partial shaving on the 45-degree cheekbone to adjust the height difference. In fact, if the position of the eye bones is different, it is difficult to correct cheekbone asymmetry.

If the asymmetry is severe, surgery on only one side is possible, and if the position or size of the 45-degree cheekbones differs, the asymmetry can be improved by performing surgery with different adjustments on each side.

Q7. Can jaw asymmetry be solved with liposuction?

A. The surgical method may differ depending on whether the cause of jaw asymmetry is bone, muscle, or fat.

To be exact, it is necessary to take an actual CT scan, and if the problem is fat, it can be improved with liposuction.

Q8. What is the earliest age at which bone growth ends?

A. Among the bones in our body, facial bones grow the slowest.

Usually, bone growth closes around ages 17–19 for men and 16–18 for women, but depending on the individual, growth may end later.

Therefore, it is best for minors to avoid bone surgery, and facial contouring surgery is generally possible after age 20.

Q9. I’ve had chin filler. Can I dissolve the filler and replace it with fat grafting?

A. Hyaluronidase, the enzyme that dissolves and breaks down hyaluronic acid, the main component of filler, will dissolve most of the filler within 24 hours if an appropriate amount is injected into the area where the filler is present. The remaining filler is gradually absorbed by the body over several days.

To accurately assess the volume, I recommend dissolving the filler at least 3–7 days before the procedure.

Q10. If cheekbone surgery is done without fixation, how likely is it that the cheekbones will protrude again?

A. For those who prefer no fixation pins, I recommend 230-degree zygoma surgery.

3D zygoma surgery naturally requires fixation, and even for those who want 230-degree zygoma surgery, if they do not mind fixation pins, I tell them to use posterior fixation.

However, even without fixation, if we take CT scans and observe the progress over 1–3 years, we can see that the bones have fused back in place without major issues.

Q11. What surgery should I have to make the side cheekbones and 45-degree cheekbones smaller?

A. First of all, for those who think the 45-degree cheekbones are very large, I recommend 3D zygoma surgery.

By taking a CT scan, you can see how large the cheekbones are. In the case of women, if the cheekbones are not large, there may not be a big difference in the results between 230-degree zygoma surgery and 3D zygoma surgery.

But basically, for people with large 45-degree cheekbones, 3D zygoma surgery can produce greater results.

Q12. Will 45-degree cheekbone shaving have a noticeable effect?

A. Right after surgery, there is not much swelling, so you can see the effect immediately.

However, after one month, you may feel that the effect is minimal because of residual swelling, but after about six months, you can clearly feel the difference before and after shaving.

Q13. Does wearing the chin strap for a longer time after surgery help prevent sagging?

A. I do not think the chin strap prevents sagging.

It is more like a bandage used to reduce swelling in the early stage after surgery, so I tell patients to wear it for one week or up to one month.

Q14. Is 230-degree zygoma surgery good for reducing side cheekbones?

A. The amount by which the side cheekbones are reduced is the same, 100%, in both 230-degree zygoma surgery and 3D zygoma surgery.

Of course, the amount may vary as you move toward the 45-degree cheekbone area, but if only the side cheekbones are protruding, 230-degree zygoma surgery alone can still produce sufficiently good results.

Thank you.