Autologous contouring the lower face

CHAPTER 35 Autologous contouring the lower face





Physical evaluation


While the neoclassical artistic paradigm recommends that the lower-third of the face be divided into equal thirds – the upper lip, the lower lip, and the chin – such rules are only of limited utility in surgical planning. One of the principal errors a surgeon can make in assessing the lower-third of the face is to limit evaluation to the chin only – particularly the bony component of the chin. Rather, not only must the aesthetics of the chin be balanced in relation to the facial structure, but it is necessary to take into consideration the stature and sex of the patient as well. When evaluating the chin, a systematic approach to the physical examination is helpful. For example, when honing in on the lower third of the face, a step-by-step evaluation from nose to chin should include the lower midface, nasolabial folds, upper and lower lip relationship, incisor tooth show, labiomandibular fold, lower lip eversion and inclination, height and depth of the labiomental fold, chin pad thickness, static soft tissue ptosis, and dynamic chin pad motion with smile.


Large-format frontal, oblique, basilar, and lateral photographs in repose and animation are essential. Posteroanterior and lateral cephalograms, as well as a panoramic X-ray, can also be helpful. Any evaluation of the lower third of the face should also include the following points:



1. Midface evaluation






2. Lip evaluation







4. Chin evaluation






Mar 4, 2016 | Posted by in Aesthetic plastic surgery | Comments Off on Autologous contouring the lower face
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