In
China and Korea, men with square faces, blunt jawlines seek reshaping surgery
for more elliptical face.
Demand
for surgical reshaping in Asia higher than in U.S.
While many pleasing outcomes can be achieved
with a high-tech device or well-placed series of injections, there are still a
host of instances in which surgery may be the better option. Case in point: the
jawline.
When a large masseter makes the jaw appear
wider, botulinum toxin can be used to reduce the size of the masseter muscles;
sometimes, part of the masseter may need to be removed. If it's a bone issue,
however, the only option is to actually remove part of the jawbone itself to
achieve reduction, says Jeffrey Spiegel, M.D., a board-certified plastic
surgeon in Boston.
The jaw, Dr. Spiegel says, may be the most
significant facial element we assess to determine gender and attractiveness,
and therefore, altering structural components of the face may be necessary to
help to create attractive faces.
"There's a growing percentage of Asian
women who have the (surgical facial reshaping) procedure because they're aware
of it," says Dr. Spiegel, who performs at least two of these procedures
per week. "In Asian culture it ranks up there, right under
blepharoplasty."
But there's a feminization trend in pockets of
Asia for men, too. While a square jawline is considered a hallmark
characteristic of the male face, in China and Korea, men with square faces and
blunt jawlines are opting to undergo facial reshaping surgery for a more
elliptical face, which is considered more complementary to their finer
features.
ASIAN STUDY According to a paper by Xiaoping
Chen, M.D., et al, International Plastic and Cosmetic Center, Nanjing Medical
University, Jiangsu, China, "The procedure in men versus women usually
requires extra care to achieve the subtle contours necessary to produce an
elliptical-shaped face."
In a recent issue of Archives of Facial
Plastic Surgery, Chen et al reported their results of facial reshaping by
ostectomy in 19 men with square faces (Chen X, et al. Arch Facial Plast Surg.
2011;13(4):244-246).
Ostectomy was performed under general
anesthesia and included resecting the mandibular angle, splitting the lateral
cortex and reducing the chin width via intraoral approach. The amount of resection
necessary was determined preoperatively and varied depending on the width of
the chin and the shape selected by the patient.
"The mandibular angle in men is usually
more prominent than that in women, which may be why simple osteotomy is
sometimes not sufficient in men," Chen et al reported.
When the osteotomy was completed, the muscular
attachments were stripped and the central segment was removed. The two separate
segments were then centered and fixed with titanium plates and screws, and the
bony edge of the mandible was trimmed with an oscillating saw. In some cases,
it was necessary to resect part of a hypertrophic masseter.
Results were evaluated at three and six months
postprocedure. Patients had natural-looking, narrow and stable mandible
contours and were generally satisfied with their appearance. Complications
included edema in the lower face (treated with 10 mg/d corticosteroids for
three days) and some difficulty in opening the mouth for one to two weeks.
BEAUTY AND BALANCE Although there's a higher
demand for surgical facial reshaping in Asia, Dr. Spiegel says one can expect
certain variables to influence how surgeons approach the face in the United
States.
"I have patients who come to me and say,
'I don't think I look attractive.' They don't need a rhinoplasty, a facelift, a
blepharoplasty. Instead, they have gender cues, such as facial shape,
cheekbones, the jawline, the Adam's apple, that need to be addressed," he
says.
Men may look too harsh or aggressive;
transgendered women look very masculine. And if surgeons are looking to create
a more feminine or attractive face, you look at these areas, Dr. Spiegel says.
As for his approach to facial reshaping
surgery, "The technique itself isn't really novel. (My approach) is
similar to their approach. But I also add contouring with soft tissue fillers —
an important part of refining the results."
In the end, creating a more balanced
appearance in some faces requires less — not less in terms of invasiveness, but
less in terms of physical bone structures — and may demonstrate a shift in how
we think about achieving beauty and balance and allowing those to drive the
cosmetic choices made by surgeon and patient.
"It's an exciting time in the field of
research. Interest in the relationship between facial attractiveness and
evolutionary biology is giving us a greater understanding into how to evaluate
faces as well as a cadre of new procedures with accurate and specific solutions
for patients," Dr. Spiegel says.
Eliza Drewa
http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Asian-trend-to-surgically-reshape-jaw-redefines-no/ArticleStandard/Article/detail/750223?contextCategoryId=40150Business & Investment Opportunities
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