Facial Wrinkle Surgery

 

694. Facial Wrinkle Surgery

Facial wrinkle surgery includes various treatments to improve wrinkles and sagging skin due to aging.

At the early stage of aging, non-surgical methods are often enough:

• Botox reduces forehead, frown, and crow’s feet lines by relaxing overused muscles.

• Fillers restore volume to deep wrinkles like nasolabial folds.

• Thread lifting helps with sagging in the jawline and lower face.

When sagging becomes more obvious, surgical facelifts are more effective. Depending on the area, techniques include:

• Upper face: forehead or brow lift, upper eyelid surgery

• Midface: cheek lift, mini-lift, lower eyelid surgery

• Lower face: lower facelift, neck lift

Mini facelift uses short incisions in front of the ear, lifting the SMAS layer at a 45° angle. It's less invasive, good for the lower face, with low nerve risk.
Extended SMAS facelift lifts the SMAS flap to improve the lower face but is less effective for the midface.
Deep plane facelift lifts skin and muscle together below the SMAS, offering excellent improvement in both mid and lower face. It heals fast and is more durable, but requires advanced surgical skill.

Intraoral dissection can release key ligaments (zygomatic, mandibular, masseteric) from the bone, helping with facial lifting, especially when combined with facial contouring surgery.

But why do faces sag again over time? It’s not just skin — facial bone loss plays a major role.

To maintain long-lasting results:
✔ Do facial blood flow exercises
✔ Sleep deeply to support bone regeneration
✔ Eat whole, natural foods to slow bone loss

Facial wrinkle surgery is about remodeling the skin and fascia over a shrinking bone structure.
– 694mm Growth Pine Tree 🌲

Facial Paralysis Surgery

 

693. Facial Paralysis Surgery

Facial paralysis surgery refers to procedures that restore balance and expression to the face after facial nerve damage, often affecting one side. The facial nerve (7th cranial nerve) controls facial muscles, so when it is injured, facial asymmetry or loss of movement can occur.

There are two main approaches:
Static reconstruction improves symmetry by lifting sagging tissue, inserting weights into the upper eyelid to help it close, reshaping drooping eyes (canthoplasty), and lifting a drooping mouth corner using materials like threads or fascia. These methods restore balance but not movement.

Dynamic reconstruction restores movement. It includes:

• Nerve grafting: Connecting branches from the healthy facial nerve to the paralyzed side (cross-facial nerve graft), or using nerves like the hypoglossal (tongue) or masseter (chewing) nerve to help regain a smile.

• Free muscle transfer: Transplanting muscles like the gracilis to the face, connecting them to nerves and vessels, allowing them to move again.

• Muscle transfer: Transposing nearby muscles like the temporalis to the mouth area, enabling a smile by clenching teeth. This is useful for older patients or when microvascular surgery isn’t possible.

But what causes facial paralysis?
Often it's a mix of factors: weakened muscles from one-sided habits, poor sleep, processed food, chronic lymphatic congestion, viral infections, or even sudden weather changes affecting facial nerve blood flow.

When negativity lingers too long and meets the right (or wrong) conditions, facial paralysis may result.
But if we shift our mindset—see life more positively and fill each day with happiness—we can protect our expressions and spirit.

Facial paralysis surgery: restoring expressions lost from a twisted mind and tense life.
– 693mm Growth Pine Tree 🌲

Facial Resurfacing Surgery

 692. Facial Resurfacing Surgery

Facial resurfacing is a procedure that removes the outer layers of skin to stimulate regeneration and reveal smoother, healthier skin beneath. There are three main types: chemical peeling, mechanical peeling, and laser resurfacing—with laser being the most commonly performed today.

Chemical peels use acids to dissolve and remove damaged skin:

• AHA (Alpha Hydroxy Acids) like glycolic acid target the epidermis, while lactic acid is gentler—great for sensitive skin.

• BHA (Beta Hydroxy Acid) such as salicylic acid is oil-soluble and effective for acne-prone skin.

• TCA (Trichloroacetic Acid) can reach deeper layers and is used for scar treatment depending on its concentration.

• Phenol peels go deepest, offering dramatic results but with higher risk and longer downtime.

Mechanical peeling involves physically sanding the skin using a high-speed rotating device. It’s often used for deep acne scars or raised moles, but comes with more bleeding, longer recovery, and high dependence on the practitioner's skill.

Laser resurfacing precisely removes skin using laser energy and promotes collagen regeneration:

• CO₂ lasers (10600nm wavelength) target water in tissues, reaching the upper dermis—ideal for deep wrinkles and acne scars.

• Er:YAG lasers are more water-absorbent, allowing gentler, more precise peeling for fine lines or mild scars with fewer pigment risks.

• Fractional lasers treat only tiny portions of the skin in columns, speeding recovery while improving scars, pigmentation, and fine lines.

• Non-ablative lasers don’t peel the skin but deliver heat to stimulate collagen. They’re safe for pigment issues and fine lines but require multiple sessions.

Since skin regeneration mainly occurs during sleep, proper sleep habits—especially before and after treatment—are essential. Late nights or insomnia can delay recovery.

Facial resurfacing is a form of skin rejuvenation where intentional exfoliation leads to purposeful renewal.

Facial resurfacing is a sculpted renewal through controlled exfoliation.
- 692mm Growing Pine Tree 🌲

Facial Scar Revision Surgery

 

691. Facial Scar Revision Surgery

Facial scar revision aims to reduce the visibility of various types of scars—raised, sunken, pigmented, pale, or contracted—to enhance appearance. Why do scars form differently even with the same incision? It’s not just about your “skin type,” but more about your lymphatic system. When lymph vessels are well-developed and clean, cellular waste drains efficiently, minimizing inflammation and scarring. However, if lymph flow is blocked or polluted—often due to processed foods—the buildup of toxins irritates tissues, leading to hypertrophic scars, keloids, or atrophic scars depending on blood supply and damage level.

To treat scars surgically, local flap techniques such as Z-plasty and W-plasty realign scars along natural skin tension lines, making them less noticeable. For deep sunken scars, dermal grafts or fat grafting can be used. Since fat graft survival may be low in scar tissue, we combine treatments like subcision, PRP (Platelet-Rich Plasma), ADSC (Adipose-Derived Stem Cells), SVF (Stromal Vascular Fraction), and hyperbaric oxygen therapy.

Non-surgical treatments also play a key role. Radiofrequency (RF) helps remodel collagen by gently heating the dermis. Laser therapy breaks down scar tissue and promotes regeneration. Low-Level Light Therapy (LLLT) stimulates mitochondria to boost cellular repair and speed up scar healing. Advanced micro-optic devices now allow ultra-fine skin grafting for even more precision. For raised scars, silicone gel pressure therapy can also be effective.

Ultimately, scar outcomes improve not just with procedures but with lifestyle: eat clean (avoid food additives), exercise to detox lymph fluid, and sleep deeply from 10 PM to 5 AM—the prime time for skin repair.

Facial scar revision is the art of making what remains... beautifully unnoticeable.
- 691mm Growing Pine Tree 🌲

Facial Bone Surgery

690. <Facial Bone Surgery>
Facial bone surgery reshapes the facial skeleton for aesthetic and functional improvements. The face is made up of 15 bones, and most are involved in facial bone surgery, excluding the sphenoid, lacrimal, and palatine bones.

Forehead bones can be reduced or filled using shaved bone or implants. Brow bones may be contoured by pushing in the frontal sinus or shaving thick bone. Temporal bones can be reduced by grinding muscle attachments and weakening the temporalis muscle for a slimmer side profile.

Orbital bone surgery adjusts the eye socket. Protruding eyes are corrected by expanding the orbital space (medial, inferior, lateral walls). Sunken eyes are corrected by filling the orbit with implants or autologous grafts like rib cartilage or bone particles.

Nasal bone surgery includes narrowing wide nasal bones and correcting hump noses via preservation rhinoplasty. A deviated septum is straightened, and inferior turbinate bone may be repositioned outward to improve airflow in cases of rhinitis.

Zygoma surgery includes reduction (moving the arch and body inward) and augmentation (enhancing the flat cheek area with implants, fat grafts, or rib cartilage).

Maxillary surgery (Le Fort osteotomy) repositions the upper jaw with the dental arch. Sunken areas around the nose can be enhanced with grafts for a fuller midface.

Mandibular surgery includes sagittal or vertical osteotomy to reposition the lower jaw. When both upper and lower jaws are corrected, it's called two-jaw surgery (orthognathic). Jawline contouring, cheekbone reduction, and chin surgery can be done independently or with two-jaw surgery.

Facial bones protect sensory organs and also shape facial appearance. Whether for trauma, congenital reasons, or beauty, facial bone surgery can be tailored to each patient.

[Facial bone surgery reshapes the bones that protect your senses into a face you want to reveal.]
– 690mm Growing Pine Tree –

 

Facial Contouring Surgery

 689. <Facial Contouring Surgery>

Facial contouring surgery aims to create a balanced, harmonious, and attractive facial shape by adjusting the contours of the face. It can be divided into upper, mid, and lower facial contouring.

Upper face contouring includes forehead or temporal contouring using fat grafts or implants to add volume. Autologous bone grafts can also be used—often by crushing bone from jaw or cheek surgeries and grafting it onto the forehead.

Midface contouring typically involves zygoma (cheekbone) surgery. Zygoma reduction reduces protruding cheekbones for a slimmer midface, while augmentation enhances flat anterior zygoma for a more dimensional look.

Lower face contouring includes square jaw reduction and chin surgery. Chin contouring can involve reducing, elongating, advancing, or setting back the chin. Combining jaw angle reduction with chin contouring helps create a slimmer, V-line facial profile—popular in modern aesthetics.

1:1 facial photos and 3D-CT scans are essential. These help analyze bone and soft tissue to determine the amount of reduction needed while avoiding nerve damage. If maxillary sinus inflammation is present, it must be treated before zygoma surgery to prevent complications.

Since zygoma reduction involves separating and fixing parts of the bone, habits like teeth grinding or prolonged chewing may affect bone healing. Botox or other treatments may help prevent nonunion in such cases.

V-line jaw surgery reduces the jaw angle and width while refining the chin. In cases with sleep apnea, genioglossus advancement moves both the chin and tongue forward to widen the airway and improve breathing.

If the skin is significantly loose—especially in patients over 40—facelift surgery may be combined. When done together, the same incision in front of the ear can be used to fix the zygomatic arch, eliminating the need for a separate sideburn incision. The detachment during bone exposure also severs ligaments between skin and bone, making skin lifting easier and more effective—even with a minimal incision. Especially for chin advancement in older patients, the lifting effect can be more pronounced.

Facial contouring surgery thus reshapes the facial bones to create a slimmer and more harmonious appearance.

[Facial contouring shapes facial balance through bone refinement]
– 689mm Growing Pine Tree –

Orthognathic Surgery

 

688. <Orthognathic Surgery>
Orthognathic surgery, or double jaw surgery, involves cutting and repositioning the upper (maxilla) and lower jaw (mandible) to correct misalignment. Ideally, the jaws align in a perfect bite, but varying degrees of discrepancy can require surgery.

The most common method for repositioning the upper jaw is the Le Fort I osteotomy. If the upper jaw is retruded (flat face), it's moved forward; for protruding mouths, it is set back. In long midface cases, especially when gums show while smiling, the maxilla is reduced to balance the distance between the eyes and teeth.

Those who chew hard food often have overgrown back maxillae, flattening the occlusal plane. By reducing the posterior part and rotating the jaw clockwise, volume in the midface increases, creating a youthful appearance and a natural smile arc.

When the lower jaw is overly developed (prognathism), it’s often due to genetics or strong chewing habits. The Sagittal Split Ramal Osteotomy (SSRO) is the typical method to reposition the mandible, while the Intraoral Vertical Ramus Osteotomy (IVRO) separates the jaw vertically.

SSRO offers wide bone contact for stable healing but carries a higher risk of inferior alveolar nerve damage, depending on nerve canal anatomy. IVRO minimizes nerve risk and is often used for TMJ disorders or severe facial asymmetry, though it may require non-fixed healing, causing patient discomfort.

In cases with a narrow airway or asymmetry, lower jaw surgery alone isn't enough—both jaws must be addressed. Severe bimaxillary protrusion may also require an Anterior Segmental Osteotomy to reduce the premolar region.

Orthognathic surgery can correct underbites, protrusions, asymmetry, long face, and sleep apnea by restoring jaw harmony. Braces may be needed before (pre-surgical orthodontics) or after surgery (surgery-first approach), so dental evaluation is essential.

[Orthognathic surgery harmonizes upper and lower jaw imbalance]
– 688mm Growing Pine Tree –