Specialists Can Correct Foundational, Age-Related Facial Concerns

For patients concerned about aging facial features or wanting to return to a more youthful appearance, a visit to the oral and maxillofacial surgeon could be the place to start.

Erik Evans, DDS, MD, a fellowship-trained oral and maxillofacial surgeon with UC Health and assistant professor of surgery at the University of Cincinnati (UC) College of Medicine, says many people don’t realize that specialists in his division are trained to perform a variety of facial aesthetic procedures along with facial reconstruction and jaw surgery.

After completing dental school, oral and maxillofacial surgeons spend four or more years in a hospital-based surgical residency, training in medicine, anesthesiology, general surgery and other surgical specialty areas. As a result, they can correct physical malformations from the process of aging, disease, injury and birth defects throughout the head and neck region.

Evans says he typically see two types of patients for facial aesthetic surgery: younger patients with what he calls "foundation” issues, like prominent ears, an unaesthetic nose or a skeletal imbalance between jaws, and older patients seeking rejuvenation surgery to lessen wrinkles or other signs of aging.

"These may be patients who are middle age or older,” says Evans. "They feel young and they just want to look as youthful as they feel.”

Many of the procedures are minimally invasive and can be performed in an outpatient office using local anesthesia. Other procedures may necessitate sedation or general anesthesia. Evans says recent advances in surgical techniques have enabled surgeons to produce outcomes that are predictable, look more natural, are less prone to scarring and have stable, long-lasting results.

Several of the most common facial aesthetic procedures by oral and maxillofacial surgeons include:
 

  • Facial skeletal augmentation to create more prominent cheekbones or chiN
  • Ear surgery (otoplasty) to set prominent ears back closer to the head, or to change the shape and size of the patient’s ears
  • Eyelid surgery (blepharoplasty) to remove fat and excess skin from the eyelids
  • Facelift (rhytidectomy) and necklift to tighten facial skin and underlying tissues,  providing a more youthful appearance
  • Forehead/brow lift to improve brow positioning, minimize frown lines and reduce forehead wrinkles
  • Nasal reconstruction (rhinoplasty) to reduce or increase the size of a patient’s nose as well as modify the shape of the tip, bridge or span of the nostrils.

Many of these procedures are performed in conjunction with one another, to achieve a natural appearance of  the face. Surgeons are also able to perform skin-smoothing techniques like dermabrasion, laser skin resurfacing and chemical peels, or inject Botox or filler materials to plump wrinkles or grooves in the skin.

Evans says patients should be prepared to have a thorough discussion with their surgeon at their first consultation. While it helps for patients to come in with an idea of what they would like, a surgeon may recommend a different procedure to achieve the desired result. Some of these procedures may also prove beneficial from a functional perspective.

"For example, some patients with concerns about dropping eyelids come in wanting blepharoplasty, or eyelid surgery,” says Evans. "But if their eyelids are too low because of their brows, a blepharoplasty may make a person look tired and, especially for a woman, gives her a more masculine appearance. For those patients, I would recommend an endoscopic brow lift to address their original concerns. This is why the correct diagnosis is so important.”
 
That means patients should not only have realistic expectations, but also establish a rapport with their surgeon before moving ahead with surgery—it’s why Evans often recommends his patients get a second or third opinion before going ahead with the procedure.

"I think getting multiple opinions on facial aesthetic surgery is a very good thing for patients,” he says. "With an elective procedure, patients can take the time to work with their surgeon to create a comprehensive plan that addresses their needs and produces long-lasting results.”

Source: University of Cincinnati