[Column] Facial Contouring Front View Effect: Why Does the Face Look Awkward After Surgery?

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

Today, I’d like to talk about the aesthetic aspects of the “front view effect” in contouring surgery, rather than the surgical method itself.

The “front view effect” in contouring surgery refers to the sense of “balance” in the front view of the face after facial contouring surgery.

It is often said that a plastic surgeon must have not only surgical skill but also aesthetic sense. So what exactly does that aesthetic sense mean?

In fact, because the standard of beauty is extremely subjective, surgery cannot be performed while ignoring the patient’s opinion.

However, the aesthetic sense a doctor should have is the ability to see the “overall harmony.”

In plastic surgery, harmony is extremely important not only for the aesthetic aspect, but also for preventing revision surgery or the patient from continuing to undergo additional procedures after surgery.

Related to this, I will explain in detail why this vicious cycle of cosmetic surgery happens.

What is a beautiful face?

Generally, when people talk about beauty, they refer to big eyes, a high nose, a small chin, and a slim face.

But what we actually feel as beautiful comes not from such partial conditions, but from the overall harmony and balance of the face.

We usually look at a pretty person and say they are pretty, rather than saying they are pretty because their eyes are large or because their chin is small.

Facial contouring surgery should also be performed in a way that makes the face look beautiful by correcting the face’s unstable balance, rather than simply making it smaller or the chin sharper. That is how good results can be achieved. I’ll explain this easily with photos.

Which woman do you think looks more beautiful, the one on the left or the one on the right?

Looking at the facial outline, the woman on the left falls in a straight line from the temple down to the lower jaw, while the woman on the right falls diagonally.

As you can see, if the facial line falls flat in a straight line from the cheekbone to the lower jaw, the midface looks longer and the lower jaw looks wider.

In fact, the absolute face length in the two photos is the same, but the woman on the left appears to have a longer face and also looks older.

Even with the same length, what is perceived relatively can change depending on the proportions.

Facial contouring surgery is a procedure that smooths out uneven areas of the face.

However, if you focus only on making the face smooth and slim, the problem area that existed before surgery may be resolved, but the face may become awkward overall, like the woman on the left.

Therefore, even if facial contouring surgery involves only zygoma reduction, it must take into account the forehead, lower jaw, facial length, and the placement of the facial features.

The sense of balance created by matching facial proportions while considering overall harmony is what we call the “front view effect” in contouring surgery.

The front view effect in contouring surgery

Let me show you an actual patient case.

This is a preoperative photo of a patient who underwent zygoma reduction.

If you look at the photo, the lower jaw is slim, but the cheekbones are relatively large, making the jaw look underdeveloped and the upper and lower balance uneven.

The lateral cheekbones are also somewhat developed, so you can see that the facial line is slightly uneven.

In cases like this, simply moving the cheekbones slightly inward can improve the overall balance of the face and make it look much better.

Considering the narrow width of the lower jaw and the length of the midface, the slightly protruding lateral cheekbones were moved inward, and the developed 45-degree cheekbone area was shaved smoothly.

If you compare them side by side, you can see that the uneven lateral cheekbones have been smoothed out and the balance between the cheekbones and the lower jaw has been corrected.

In this patient’s case, the cheekbones on both sides were moved inward by 5 mm each, reducing the total facial width by 1 cm.

The absolute amount of change may be small, but considering overall harmony, this is the direction in which the patient would be most satisfied after surgery.

Why patients keep having surgery

Lastly, I will explain the vicious cycle that occurs when surgery is performed without considering harmony.

The photo on the left is a hypothetical image of the result one might expect if surgery is performed without considering the “front view effect” and instead focuses on reducing face size or creating a dramatic change.

Compared with before surgery, if you look only at the degree of absolute change, the left side can be said to make a bigger difference and to have a narrower, slimmer face width.

However, because the cheekbones fall flat, the midface looks longer and the center of gravity of the face appears to drop downward.

The slim chin before surgery looks wider after surgery, and now it appears as though square jaw surgery is needed instead.

I am showing this because among people who have had incorrect zygoma reduction, there are many who end up with a face shape like the one in the left photo.

If square jaw surgery is then performed, the chin will clearly start to look too long or unnatural, and as surgeries continue one after another, the face becomes increasingly unnatural.

The same applies to square jaw surgery. If too much bone is removed in an effort to make the face as slim as possible, the upper and lower balance of the face is once again disrupted, increasing the likelihood that the patient will return to the clinic feeling that the cheekbones, which were not a problem before surgery, have become larger.

Or, in cases where fat grafting is done excessively, the nose may appear low, leading to rhinoplasty; or after making the nose higher, another area may look empty. These are all of the same nature.

In this way, being able to see the harmony of the face is important beyond aesthetic sense, because it helps prevent patients from undergoing revision surgery and then additional surgeries on other areas one after another. Solving a long-standing complex with a single surgery is a good thing, but continuing to visit the clinic is also not desirable from a doctor’s perspective.

For those of you currently considering cosmetic surgery, I urge you to judge carefully and be wise so that you do not end up with unsatisfactory results due to excessive desire, or find yourselves needing another surgery after the procedure.

Thank you.