Facial Aesthetics

Characteristic Features of the Asian Face

Facial Aesthetics | Rhinoplasty | Blepharoplasty | Chin Surgery | Jaw SurgeryThe Asian face tends to be relatively large, wide, and flat when compared with the Caucasian. The cheek bones may be more prominent, as may be the jaw bone. In females, an overdeveloped cheek bone or jaw bone is sometimes seen as making the face look more masculine.

At the same time, the forehead may be comparatively flat or even retruded, or pushed backward. Some people with especially noticeable retrusion may choose to undergo cosmetic surgery to increase forehead projection using one of three very different approaches: fat injections, contouring with bone cement, or placement of a silicone implant, Forehead augmentation is a “distinctly Asian “form of plastic surgery in that such procedures are essentially unknown in the West and are seldomm offered by plastic surgeons outside of Asia.

While well–developed cheekbones with good forward projection are highly valued by those of European descent, some people of Asian descent born with particularly full faces prefer a slimmer appearance from both front and profile views. Prominent cheekbones make the uppermost mid-faced wider, while overly ample cheek fat can thicken the lower portion of the mid-face.

Two surgical approached can be employed to decrease cheek size: bone reduction and buccal fat removal. CT scanner can be used to determine the position of muscles, fat and eve nerves for ma more complete analysis during planning. When endoscopes used, smaller incisions can provide a faster recovery.

Today, the anatomical nuances that distinguish Asian anatomy along with the cosmetic desires more unique or important to the Asian population are better understood.

Listed below are the plastic surgery procedures that we offer:

Rhinoplasty

Facial Aesthetics | Rhinoplasty | Blepharoplasty | Chin Surgery | Jaw SurgeryRhinoplasy is one of most frequently performed Asian cosmetic surgeries. Although the general concepts of Asian rhinoplasty are similar to those in the non-Asian, technical execution is different. Asians generally seek augmentation rhinoplasty, in contrast to Caucasians generally request reduction rhinoplasty.

The nasal bridge is typically flatter, less defined, and the tip of the nose wider and less angular. The nostril opening may appear relatively larger and be more widely flared. For the Asian rhinoplasty surgeon, the operation can be more challenging because Asian cartilage is more fragile and the overlying skin is thicker. Many Asians patients request an increase in tip projection to lengthen the nose slightly and lower its typical upward angled nasal tip.

Dr. Choi does not use synthetic material to augment bridges. He has used diced cartilage graft in nasal surgery more than 25 years.

There are three methods of diced cartilage in rhinoplasty surgery:

  1. Diced cartilage
  2. Diced cartilage wrapped in fascia
  3. Diced cartilage covered with fascia

Pieces of diced cartilage without any fascia can be placed in multiple areas.

Diced cartilage can be from patient’s own ear cartilage, rib cartilage, or radiated cartilage.

In anyway these are superior to alloplastic, synthetic implant so patient can have permanent, safe and infection free surgical outcome.

Diced cartilage make rhinoplasty in Asian simple and complications have been relatively minor and their correction is simple.

Every nose is different so the surgical technique is also different.

Long Nose

Main emphasis need to address to shorten and rotate the nasal tip slightly to give adequate balance and satisfy the rule of three principles.

Short Nose

This nose gives appearance of piggy nose and it requires lengthening of the nose. Radiated cartilage or patient’s own ear cartilage can be used to lengthen and it is associated with tip projection.

Wide Nasal Nose

This nose typically requires osteotomy (breaking the nasal bone) to reduce the width of the nose and osteotomy is performed routinely in Caucasian nose.

Drooping Tip Nose

This gives appearance of aged nose and it requires rotation to bring the nasal tip toward upward and it gives young looking and youthful appearance.

Wide Nasal Base

This is very common among South East Asian but 20% of North East Asian also had this configuration. In this case, alar base is reduced by excising portion of the nasal base and the scar is invisible after healing is completed.

Bulbous and Thick Nasal Tip

This is very common and shaping the nasal tip cartilage and reducing the fatty tissue from underlying skin thick nasal skin can be thinned.

Double Eyelid Surgery (Blepharoplasty)

Facial Aesthetics | Rhinoplasty | Blepharoplasty | Chin Surgery | Jaw SurgeryDouble eyelid surgery is the most popular of all facial plastic surgery procedures performed on patients of Asian descent in the Orient and West.

It is an operation designed to create or enhance the upper eyelid crease. It will make eye bigger and the eyelids look more opened. While most of the structured of the Asian eyelid are identical to those found in the Caucasian lid, their different structural alignment and relative lengths and thicknesses are sufficient to account for the highly characteristic appearance of the typical Asian upper lid, epicanthal fold, and crease.

Many plastic surgeons consider eyelid surgery to be the most demanding and least forgiving of all plastic surgery procedures. Patient satisfaction after eyelid surgery is surprisingly low, a refection of the expertise required to perform these operations successfully. Results can vary tremendously with the training, skill, and experienced of the doctor, and problems such as noticeable asymmetry, excessive scarring, misdirected eyelashes, unwanted accessory skin folds, hollowness, overdone or unnatural results, and a gradual loss of the crease are by no means rare.

Surgical Methods

Cutting Techniques

Among many different techniques, wide undermining the lid skin and aggressive removal muscle technique deliver most attractive result based on Dr Choi’s 12,000 eye lid surgical experience.

  • Requires incision
  • Leave scar
  • Healing and recovery takes longer
  • Revision surgery may be difficult occasionally
  • Requires skill from surgeon
  • Deliver permanent result
  • Good for thick skin
  • Good for fatty eye
  • Able to prevent puffy crease
  • Less fold failure rate

Non Cutting Technique

There are numerous techniques and so far most reliable technique is DST (double sutures and twisting method) which was designed by the Japanese surgeon.

  • No scar
  • Quick healing
  • Easy to revise
  • Less skilled surgeon can perform
  • Good for thin skin
  • Good for younger patient
  • Fold failure rate is higher than cutting technique
  • Not good for thick skin
  • Not good for fatty eye
  • Not good for saggy lid

Shape and Size of the Fold

Facial Aesthetics | Rhinoplasty | Blepharoplasty | Chin Surgery | Jaw SurgeryTaper

This is most desirable to the patients who are looking for typical Asian appearance and very natural looking fold. 50% of natural crease belong to this style and young patients prefer to this style. Typically the size is somewhat smaller and usual size of the crease is less than 6mm. Non cutting technique can deliver this kind of style of crease.

Parallel

Somewhat larger than tapered crease and resemble Caucasian fold. It is somewhat larger than tapered look and also 50% natural crease belong to this style.

Medical Epicanthoplasty

Epicanthal fold is sometimes called as a Mongolian fold and it is small web like skin covers the inner corner of the eye. Removing this fold is called medial epicanthoplasty and it enlarges the eyes in horizontal direction. 10 to 15 % of the eyelid surgery requires this procedure. This procedure is recommended to someone’s horizontal length of the eye is less then 2.5 cm and if the size belong to between 2.5- 2.7cm then occasional recommended. Anyone whose eye is larger than 2.7cnm then usually this procedure is not necessary. For general information Caucasian eye size is somewhat 3cm in length.

There are numerous techniques such as V-Y advancement, W plasty, Z plasty, and modified Z plasty V-W plasty but due to high incidence of the scarring I recommend lazy S flap. Typically this procedure require 30 minutes of operation time and it is usually performed with Asian Eyelid surgery. It will take 6 months until scar is totally invisible.

This technique gives least chance of scar formation but every epicanthoplasty need to be performed with very careful consideration.

Step by Step of the Surgery

Actual Patient

Chin Surgery

The chin has been called the “anchor of the face” and may greatly alter perception of the lips, nose, and jaw. In the Asia a protruding chin sis seen as a masculine feature, while a retruded chin cam make the face look square from the front and underdeveloped in profile. Side profile or facial asymmetry can often be better balanced by undergoing either augmentation, reduction, or moving the bones of the chin.

Jaw Surgery

Facial Aesthetics | Rhinoplasty | Blepharoplasty | Chin Surgery | Jaw SurgeryUpper jaw bone is known as the maxilla, while the lower jaw bone is called the mandible. For the mandible and its main muscle, the masseter, are the primary anatomic factors determining the width and shape of the lower called the “jaw line.”

Some Asian women prefer a more slender jaw profile to a stronger square or flared contour that might feel out of proportion to other more delicate facial features. Slimming does soften the facial contour and cam make the neck appear slightly longer. Some women feel a square jaw line makes them appear less feminine, although this argument is flawed. There are countless beautiful women with extremely square jaws and many handsome men with highly angled jaw. Jaw line reduction can be undertaken using either permanent surgical or temporary non-surgical methods.

Surgical reduction of the mandibular angle is particularly effective in changing a square –shaped face into one with a more oval contour.

Facelift (Meloplasty)

With respect to facelift, anatomical factors that distinguish the Asian face from the European face include thicker skin, more fat accumulation in the lower face and neck with aging, a more prominent buccal fat pad, and flatter facial skeleton that renders the heavier tissues of the lower face more susceptible to the downward pull of gravity.

Asian Liposuction and Fat Transfer

Facial Aesthetics | Rhinoplasty | Blepharoplasty | Chin Surgery | Jaw SurgeryKorean woman is the least obese in the world; they are also worry about weight control above almost any other cosmetic concern. Their interest in liposuction, however, is not shed more pounds but desire to remove localized stubborn fat deposits that won’t respond to diet and exercise. So many advancement in liposuction made in recent years.

Fat transfer procedures, on the other hand, address the opposite problem by moving fat from one area of the body to another where it appears to be deficient. Both types of procedures work well on the Asian face and  body as long as the surgeon understand and respects the differences in Asian bone structure, skin quality and adipose tissue distribution.

Other Procedures

  • Baggy and Saggy Lower Lid Surgery — removes the skin, protruding fat, and tightens the skin to create young appearance.
  • Under Eyebrow Eyelid Procedure — remove excessive skin on upper lid without touching upper lid skin
  • Brow Lift — reposition of the saggy brow thus create open look.
  • Cheek Reduction — reduce the size of the cheek to create softer look.
  • Lip Enhancement — improve the shape and size of the upper and lower lips.
  • Surgery of Protruding of the Ear (Otoplasty) — Bring back the protruded ear to the side of the face so create harmonious facial proportion.

Body Non-Invasive Procedures »

To learn more about our Facial Aesthetics Procedures, please contact us at (323) 737-1717 today to schedule an appointment.

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