Having an oval face is the dream of many people's minds; but pie face or square face is the usual face shape Oriental has, especially with the northern national origin of Mongolia and Korea, the rate is very high; in Taiwan, the square face is less than Korea, but the tall cheekbones or square jaw bone is very common to see.
 
People with particularly developed cheekbones, the cheeks will be relatively large and slightly raised to the front, the so-called "pie face".
People with developed jaw bone, face shape will be particularly square and large, side view there will be an unexpected angle, called "square face".
 
Facial face can be divided into the following categories:

Oval face

Diamond face

Round face

Pear-shaped face

Short square face

Rectangular face

Side：
 

凸嘴

凸嘴下顎內縮

凸嘴長臉

下顎整體凸出

後縮下巴

戽斗下巴

By changing the sleeping posture to improve the shape of the skull, only one year old infants and young children have effect; in the period of children to teenager fastest growing development, face shape with bucket or buck-tooth, you can correct with dental treatment in advance to prevent or improve; but there is no way to prevent square face or pie face. In general, after 16 years of age, facial bone has completely developed, intend to change, have to rely on plastic surgery to reach the goal.

The basic elements that make up the face shape include hard tissue (bone) and soft tissue (skin, fat, muscle), so the method of changing the face shape is also divided into "bone surgery" and "soft tissue surgery", according to the different needs, choose their own way:
Bone surgery - bone is the basis of the face shape, skeleton plastic surgery is the best of all with the best results, and even change face.
Soft tissue surgery - soft tissue is the appearance of the face, but also the place for important nerve and vascular tissue pass through; the effect of soft tissue plastic surgery is not obvious, can be used to improve the appearance, but not easy to have the effect of change face.
 
People need to change or intend to completely change the face, choose bone surgery.
→ Related articles: facial bone sculpture method、zygomatic arch osteotomy push、jaw angle excision、chin surgery
 
People do not dare to try hard plastic or just need a small improvement, choose soft plastic. Soft plastic surgery is divided into injection of botulinum, autologous fat transplantation, facial liposuction.
→ Related articles: fine talk about soft plastic surgery and surgical methods
 

 

1. Whether symmetrical or not
   The probability for the square face both sides of the jaw bone to develop asymmetry is high. Before surgery must be correctly diagnosis, to distinguish the problems belongs to the bone or soft tissue, choose surgery to be amended.
2. Whether the masticatory muscles are overweight
   People with simple masticatory muscles overweight, can choose to inject botulinum, but only temporarily; you can also choose osteotomy, get permanent effect. Surgery does not need to remove the muscle, because the muscles will naturally shrink after surgery, but it takes 3 to 6 months for face shape to be completely fixed down.
3. Full and hypertrophy face shape
   Can also do facial liposuction surgery or remove part of the oral wall fat. The ratio of the chin must also be considered, square face people often have too short jaw problems, can do the chin plastic surgery, to strengthen the overall coordination.
4. Whether the face skin is loose
   People with loose cheek, after the cheekbones bone grinding surgery, may deteriorate, can consider doing pulling surgery at the same time. If it is to do zygomatic reduction and zygomatic arch shift surgery, there will be no such consideration.
5. Are there any other requirements for plastic surgery?
   The most common surgery for face-shaped sculpture surgery is double eyelid and nasal plastic surgery.

1. Masticatory muscle injection of botulinum
   Botulinum can reduce the volume of masticatory muscles, very helpful to improve the jaw curve.
   ◆ Method: direct injection in the masticatory muscles
   ◆ Time: the first week of feeling bite strength reduction, the obvious effect appeared after a month, the effect lasted for six months (favor to bite hard food time will be shortened). Recommended injection once every 6 to 8 months .
   ◆ Effect: masticatory muscle hypertrophy effect is obvious, bite force reduction, can improve the night molar or migraine symptoms, no effect on the mature skeletal shape, (mature bones are not affected by botulinum injection, but after six months of bone surgery recovery period, the injection of botulinum can prevent bone regeneration) must be injected regularly to maintain the effect.
   ◆ Advantages: simple and safe treatment, no recovery period, eliminating the fear of surgery
   ◆ Disadvantages: the effect is often not as expected, the cost is not cheap and must be regular injection, poor economic efficiency
   ◆ Applicable: good skeleton condition, but people with masticatory muscle hypertrophy affect the jaw curve, after the bone sculpture, the prevention of bone regeneration, people with night molars or tension type migraine symptoms.
    
2. Face fat plastic surgery
   Fat has always played a very important role in the face, its quantity, health or not, deeply affect the aesthetic feeling. Fat is also an important structure that protects vital organs from the maintenance of young skin and supports elastic fullness is definitely not the general imagination of the rubbish. So, unless necessary, do not change it in any way.
   
   2-1 Autologous fat transplantation: Many people have cheek depression troubles, because it looks haggard old, most people intuitively think of "make up fat", that the depression can be filled to improve, but sometimes got the disappointed result, because the face becomes larger. This is because there is no proper distinction between "true" and "false" cheek depression before surgery. This idea must be clarified first in order to choose the correct surgical method.

• I-Cut Method  
• L-Cut Large  
• L-Cut Method
• L Cut + Truncate can zoom in and out

正面顴骨位置

側面顴骨位置

數種切割法

Zygomatic arch push principle:
(Figure 1) the widest point of the face shape is in the temporal bone arch back, zygomatic arch push to effectively narrow the face shape.
(Figure 2) zygomatic arch push, the back more than the front end, visual angle changes then can meet the narrow demand.
(Figure 3) zygomatic arch inside only adipose tissue and temporal muscle, adipose tissue can be compressed, therefore, can do the zygomatic arch push.
(Figure 4) zygomatic arch after the push will leave a small part of the prominent, it is the teeth joints, must be retained.

臉形雕塑講究的是視覺重組的概念 ，醫師在每個人不同的基礎條件下，做出最恰當的專業判斷和技術支持，透過調整比例和線條，提升立體度。術前和醫師的溝通很重要，是因為「 工作關係」呢，還是個人單純的「追求美麗」，不同的需求會有不同的作法，如：

• 職業因素，需要上鏡頭的話，可以強調線條感。
• 非職業需求的考量，我們就讓線條符合自然。除此之外，想要偏成熟感呢或是可愛感，也都會有不同的作法。

Ｕ形下巴

菱角下巴

短下巴

長下巴

標準下巴

不對稱下巴

後縮下巴

標準下巴

戽斗下巴

下巴整形在臉形雕塑裡扮演著很重要的位置，下巴的調整可以達到較大幅度的視覺假象，雕塑臉形未必只能靠減法，如:臉太圓，除下顎骨的削骨外，也可以是透過下巴延長手術，去調整臉部比例 。下巴手術是例用手術縫線控制下巴外形，在不影響正常功能的情況下，將肌肉固定在我們希望的活動範圍內，不讓它外擴。手術方法分為以下幾種：

1. 磨骨（改善有限）
2. 人工骨填充
3. 截骨手術（延長、縮短或縮窄）
4. 下巴肌肉縫合

人工骨填充示意1

人工骨填充示意2

人工骨填充示意3

Dr. ZongRu Tsai physician innovation breakthrough
Small angle long axis cutting method
Full titanium staple fixation
Do not use bone graft to fill the gap

General common cutting method
Large angle short axis cutting method

• 上切點：最高點不超過咬合面為原則。
• 定位點：保留寬度決定了定位點；定位點決定了手術結果。
• 下切點：不同定位點，得到不同的切點。
• 保留寬度：建議保留1.5~2.5cm
• 切除寬度：平均介於1.0~2.2cm

• Face swells
  Continue for 2 weeks to 1 month, can prevented or slowed down by positive icing.
   
• wound bleeding, produced hematoma or bruises on the skin
  The purpose of equipped drainage tube and the use of elastic bands is to prevent or slow down these problems. Avoid premature massage of the wound, prevent serious bleeding.
   
• The cheek or the perimeter of the mouth is dull
  A small number of patients will have this condition, because the wound swelling after surgery, facial sensory nerve caused by oppression. Avoid overheating food and prevent accidental burns. Usually takes 2 to 4 weeks of time, wait till the wound swelling elimination then will recover. Very few cases will occur under the "lower orbital nerve" or "lower alveolar nerve" damage, resulting in oral cavity or cheek permanent perceptual paralysis. Experienced physicians can avoid such damage.
   
• Difficulty to open mouth
  Because caused by the masticatory muscle swelling or wound swelling; after swelling elimination will slowly recover, it takes about 2 weeks.
   
• facial nerve injury
  Temporary facial nerve palsy - caused by normal pull during surgery, or wound swelling. Zygomatic surgery may occur the phenomenon of disappearance of the nose pattern; jaw bone surgery may occur on both sides of the asymmetry phenomenon. The probability of occurrence is not high, and after 2 to 3 months will slowly recover.
  
  Permanent facial nerve injury - the probability of occurrence is very low, mostly related to the jaw bone surgery. Many professional design of oral surgery equipment, can avoid such sequelae. However, surgery still need for experienced surgeons to perform, to ensure that surgery is safe and effective.

1. Lipid surgery - fat extraction
2. Fat essence - fat purification essence
3. Fat implantation - the essence of the body fat injects back into specific parts of the body

• Face (10cc-100cc)
  Transplant the fat into the subcutaneous tissue location: the eye, the eye concave, tears, apple muscle, husband and wife palace, forehead, smile lines, marionette lines, bridge of nose, tip of nose, chin, upper and lower lips, neck, almost all parts of the face can use fat transplantation fill surgery to restore the appearance of youth. In addition to the increase in volume, adipose stem cells in the growth factor can also allow implantation of subcutaneous collagen regeneration, can effectively reduce the fine lines!
   
• Breast (25cc-400cc)
  Each fat transplant can increase the breast about half to two cups, depending on the condition:
  1. The amount of fat to be transplanted
  2. The size of the area where the breast itself is available for transplantation
  In addition to beauty, for breast cancer surgery because of local or total removal of the breast caused asymmetry, or because of surgical scars caused by depression and the atrophy of the breast after radiation, also have excellent treatment results.
   
• Buttocks (100-1000cc): peach buttocks, buttocks.
  the back of the hand, the instep: correct chicken hands, chicken feet.

1. Trace output
   The use of fine autologous fat gun, fat particles can be the smallest to achieve 1/240 ml, fat survival rate will be greatly improved!
   According to the theory of Carpaneda physician, during the fat transplantation each time the fat ball transfer into the body, its’ radius preferably less than 2 mm (1 mm ≦ r ≦ 2 mm), in order to have the best survival rate. According to this theory, each milliliter syringe filled with fat, if the injection of a radius of 1 mm fat ball, each milliliter must be injected 240 times to achieve this goal! Fine autologous fat gun can accurate and precision reach 240 times per milliliter output.
    
   Many after the fat transplant surgery, due to the implanted ball volume is too large, resulting in adjacent tissue cannot transmitted nutrition to the central part of the ball, and metabolic waste cannot be successfully discharged from the periphery, causing the so-called central necrosis, through fine autologous fat gun, necrotic situation significantly reduced, survival rate effectively improved.
    
2. 360-degree multi-directional output
   When the doctor is doing the implementation of fat transplantation operation, often because the injection needle tip fixed opening side cannot change the direction, must always rotate the wrist angle to change the output position, effort and inaccurate! The patented syringe chuck structure of the fine autologous lip gun is not only free to adjust the direction of more than three hundred and sixty degrees, but also have the indication of the clear direction, which can provide the doctor with judgment basis to change the direction of the output, improving the efficiency of surgery, even can accurately transfer the fat to the location to be implanted!
    
3. Impenetrability controlling reduces possible air contact and relative contamination opportunities
   Most commercially available fat grafts use their own metal push rods to replace the putters with 1 ml syringes, often causing the filled adipose tissue exposed to the air. The impenetrability controlling of the fine autologous fat gun will not cause the fat inside the syringe to be exposed, reduce the chance of fat exposure to air, and reduce the chance of contamination and infection.
    
4. Multi-stage control
   Adipose transplantation should be with the difference of surgical site anatomical location and the individual differences of the organizational structure, to elastic adjust the amount of fat injection volume, fine control of the operation movement of each injection volume, is the key step of fat transplantation to the success or failure. The patented "multi-stage controlled injection system" of the fine autologous fat gun provides physician the choice of multi-stage adjustment of the injection volume from 1/60 ml to 1 / 90,1 / 120,1 / 150,1 / 180,1 / 240 ml, according to different needs, anatomical location and tissue structure, elastic select of the required injection of each output volume, accurate and fine injection of fat particles. 
    
5. Stable and accurate output volume
   In some parts of the body injection site, due to the more tough subcutaneous connective tissue structure, must according to this repeated back and forth to push and pull needle action, to pound loose the tissue, so can inject microinjection of fat, injection needle repeated action (repeated back and forth to push and pull the needle) too much damage and impact, resulting in postoperative difficult to avoid the bruises and swelling. Fine autologous fat gun patented action system, with the pre-determined precision output volume and each accurate push, regardless of the size of the power of the physician, the speed of injection or not, can be deducted by each trigger action operation, each push the output volume is stable, consistent and accurate and accurate fat ball, a large number of reduced the planting area back and forth rubbing of ​​the drill hole type, so that the recovery period is greatly shortened, the patient swollen blood stasis appearance is also far less than other traditional surgical methods.

• Light waves, such as pulsed light, laser
• RF radio waves, such as electric facelift

• Heal wrinkles
  Repeat some of the expression for a long time, the surface fine lines and smooth cut will slowly show, in the time of careless, the skin of collagen and elastic fibers gradually disintegrate, the skin loses its elasticity, so that fine lines see more obvious, people look older, less vibrant, these facial expressions are called dynamic wrinkles. Botulinum has been widely used in orthopedic surgery and medical cosmetic industry, and its main uses include the elimination of wrinkled brows, headlines, crow's feet, lip lines, chin wrinkles, small wrinkles below the eyes and so on.
   
• Modify the face contour
  More rounded or more square shape will give people the feeling of difficulty to distinguish fat and swollen, it is difficult to highlight the facial contours (commonly known as the square face), generally due to their own particularly strong masticatory muscles, support by cheeks bone on both sides of the cheek, by injection botulism in the masticatory muscles, can be temporarily contraction, so that the cheek bone flattened to achieve the modification of facial contours, soften the facial lines to improve the square face, neither bear the risk of surgery, also immediately achieve the effect of small face.
   
• Beautify arm and calf curves
  In order to achieve the ideal for the arm muscles and calf muscles shaping effect, some people choose aerobic exercise, the results make the two muscles more developed, stout, compared to other parts of the body, arms and calves most are muscles, excessive exercise will disguise forged muscle, for the arm, calf muscles, can do botulinum to make modification, let the local lines to be more perfect.

• 1989 US FDA officially approved its medical use, so far the world has more than 70 countries approved the use.
• In 1994, the Hong Kong Department of Health approved the botulinum toxin and was used in medical and cosmetic wrinkles.
• In 2002, the US FDA formally approved its eyebrow wrinkle effect.

• Do not do facial massage on the day of injection
• Injection of a week appeared to reduce the phenomenon of strength, muscle has not significantly reduced
• Injection of a month showed significant muscle reduction phenomenon
• The effect of maintaining six to eight months, people like to chew, time will be shortened
• Every six months to one year repeated the injection in order to maintain the effect

• cannot accept face-shaped surgery, just want to improve the face shape of the people.
• purely masticatory muscle hypertrophy type
• masticatory muscle hypertrophy, and ready to accept the lower jaw angle surgery, early in the week before surgery can reduce postoperative swelling and pain.
• just after the removal of the jaw angle surgery, injection can prevent bone regeneration.