Bone Reduction & Genioplasty

Face shape sculpture

The good and bad of face shape, in addition to the difference between the size and width, the difference produced by visual effects is actually more important. Face shape surgery is definitely not only a matter of making the face smaller, but also consider the proportion, lines, skin quality and other comprehensive assessment of the problem. Good visual effect is usually to increase the three-dimensional sense, which is the goal for face shape sculpture to pursue. Bone is the basis of the face shape, so the skeleton of plastic surgery is the best result and the most obvious of all operation method, people who need to significantly change or want to completely change the face, the only choice is the bone surgery.
 
The main parts to form the face which is A. cheekbones B. jaw bone C. chin, through the cheekbone surgery to change the width of the face shape, jaw bone surgery can change contours of the face shape, chin surgery to adjust the ratio length of the face shape:
A. zygomatic osteotomy internal push surgery has a variety of different cutting method: I-shaped, small L, large L, large L cut + truncated.
B. jaw bone surgery is divided into: 1. grinding bone 2. jaw angle split 3. jaw angle cut.
C. chin surgery is divided into: 1. grinding bone 2. artificial bone filling 3. cut bone.
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Introduction to Sculpture

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 Oval face
Diamond face Diamond face
Round face Round face
Pear-shaped face Pear-shaped face
Short square face Short square face
Rectangular face Rectangular face

Side:
 

凸嘴 凸嘴
凸嘴下顎內縮 凸嘴下顎內縮
凸嘴長臉 凸嘴長臉
下顎整體凸出 下顎整體凸出
後縮下巴 後縮下巴
戽斗下巴 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 methodzygomatic arch osteotomy pushjaw angle excisionchin 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
 

Dr. Roye Tsai
Dr. Roye Tsai Said...
People need to change or intend to completely change the face, choose bone surgery.
→ Related articles: facial bone sculpture methodzygomatic arch osteotomy pushjaw angle excisionchin 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
Scarf Sculpture Method
Facial bone surgery is the cosmetic surgery developed from the craniofacial reconstruction surgery, the two operating skills are similar, the biggest difference is that the former pay more attention to the beauty and visual effects, so the results will be different.
 
Related to the face shape include: cheekbones, jaw bone and chin.
Other facial operations include: forearm bone, brow and nose bone. Is also a common facial bone sculpture surgery.
The good and bad of the face shape, in addition to the difference between the size and width, the difference produced by the visual effects actually more important. Good visual effect is usually to increase the three-dimensional, which is the goal for the face shape sculpture to pursue. Changing the bone is more likely to achieve this goal than changing the soft tissue, because the shape of the bone is fixed and it is easy to do the visual effects required by the surgical design. Relatively, the soft tissue shape is not fixed, often do not get a good visual effect, sometimes it is worse.
Cheekbones, jaw bone, chin Forearm bone, brow, nose bone 
Surgery must consider other factors:
  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.
Soft Plastic Surgery and Surgical Methods
Soft Tissue Sculpture Method: Soft tissue includes skin, fat and muscle. Reduce the volume of subcutaneous fat or masticatory muscles can improve the face shape. Methods as below:
  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.
True cheek depressionFalse cheek depression
There is no prominent problem for skeleton, simply created because of subcutaneous fat atrophy (too little fat or thinner to make the cheek depression), then you should choose fat transplant surgery.Cheek depression is caused by prominent facial skeleton, mainly cheekbones and jaw angle. Although the fat transplant surgery can improve the depression, but the face becomes larger; choose facial bone sculpture surgery, can change the face shape, also can improve the cheek depression.

◆ Method: extract the thigh or abdominal fat, after centrifugal screening, and then inject a good fat to fill deep under the face skin. Each site filled with 10 ~ 20cc.
◆ Time: part implanted fat will be decomposition and absorption, about 30 to 50% survived to become a stable support force. All need two to three months. Sometimes in order to get the desired outcome of the operation, the physician will deliberately implant more fat then after the absorption the left amount of fat just meet the needs, before that, surgery patient must tolerate the cheeks up the temporary sequelae, need for three to six months. Sometimes the fat will gather to form fibroids, will touch the lumps, to wait patiently and massage. Will gradually disappear, take more than six months.
◆ Effect: Successful surgery will make face look better, younger. Often need more than two operations to maintain good results. The results of surgery will change with the change of body fat and thin.
◆ Advantages: simple and safe surgical methods, cheap, less sequelae.
◆ Disadvantages: physicians are not easy to accurately control the number of implanted fat, often need a second operation, causing unnecessary distress. Facial lines change flat, little visual effect (less three-dimensional change ). Surgery results will change with the body fat and thin, persistent uncertainty.
◆ Apply: true depression, including: cheeks, temples, eyes, tears. Face other fill, including: the front jaw, chin, nose.
 
2-2 Facial liposuction surgery: Many people complain that the face is too big, want to face-lift, intuitive think that liposuction surgery can change face shape, but often only get disappointed. Because the face of the main culprit is the bones, just by removing the fat cannot get the satisfy results. Sometimes, in order to get better results, fat pumping too much, so the skin loss saturation, instead get the result of aging feeling. Before do facial liposuction, should determine whether the shape of face is good or bad with the skeleton, but also to avoid excessive fat, so as to avoid the occurrence of aging sequelae. Method:
Traditional: the face dedicated lipstick tube to extract the subcutaneous shallow fat, deep fat, too close to the nerve cannot extract.
Shock type: relatively new liposuction tools, you can extract more deep fat.
◆ Time: just finished surgery because of swelling cannot see the effect. Be patient for three to six months
◆ Effect: can improve the face shape, but the change is limited.
◆ Advantages: simple and safe method, people with full subcutaneous fat is very effective.
◆ Disadvantages: physicians are not easy to control the precise amount of extraction, and occasionally need second surgery can only improve the face shape, visual effects are not ideal, usually only as a result of adjuvant surgery, the result will change with the body fat and thin, persistent uncertainty.
Dr. Roye Tsai
Dr. Roye Tsai Said...
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.
Brachial Arch Osteotomy
Zygomatic arch contains part of the cheekbones and part of the temporal bone, two bone junctions is nature weakness, a good place easy to break bone.
Zygomatic arch osteotomy within the push surgery, change the visual angle is the focus of this operation, not just change the size of it.
There are many different cutting methods:
  • I-Cut Method  
  • L-Cut Large  
  • L-Cut Method
  • L Cut + Truncate can zoom in and out
 
 Brachial arch osteotomy 正面顴骨位置
 Brachial arch osteotomy 側面顴骨位置
many different cutting methods 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.

 Brachial arch osteotomy
 Brachial arch osteotomy
Dr. Roye Tsai
Dr. Roye Tsai Said...
Chin surgery

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 U形下巴
菱角下巴 菱角下巴
Positive short chin 短下巴
Positive short chin 長下巴
Positive short chin 標準下巴
不對稱下巴 不對稱下巴
後縮下巴 後縮下巴
標準下巴 標準下巴
戽斗下巴 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

Chin osteotomy can be used to extend the chin, shorten the chin or narrow the chin.
Will horizontal truncate the chin bone, do the appropriate move, before, after, up, down or compound mashup move to reach the chin push forward, backward , elongate, shorten purpose.
Common cutting method - large angle short axis cutting method, is in accordance with the guidance of textbooks, large angle, short axis cutting, technology is simple, fast, but easy to leave a clear fault, not easy to polish, resulting in appearance defects and problems.
Cai Zongru physician innovation breakthrough, exclusive cutting method - small angle long axis cutting method, switch to small angle, long axis cutting method, can completely eliminate the fault defect, so that the results close to a perfect perfection, but the higher difficulty, unskilled physician is not easy to use.
General common cutting method
下巴截骨手術 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
下巴截骨手術 General common cutting method
Large angle short axis cutting method
Dr. Roye Tsai
Dr. Roye Tsai Said...
Surgical design principle of jaw angle
The principle of the mandibular sculpture is simple, that is, to minimize the prominent part of the bone to both sides, or to properly cut the prominent part to create a beautiful arc.
 
The mandibular bone is a skeleton of a three-dimensional U-shaped structure. The detailed structure includes: the lower arch, chin, jaw body, jaw angle, jaw branch and temporomandibular joint condyle. Among them, the closely related part to the face shape: chin, jaw angle and the jaw body.
(Anatomical illustration of the jaw bone)
 
The jaw angle can be divided into many different types, including: oblique square, round square, square, and square.
Jaw angle can also be in accordance with its three-dimensional structure tendency to divide into "outer type" and "inverted type."

Jaw angle is the place where the masticatory muscles are attached, will be affected by the chewing habits and change the shape, so people who like to chew or like to eat beef jerky and other food, in addition to masticatory muscles will become hypertrophy and make face wide, But, also make the jaw angle more developed, so that the face is more prominent.
 
The shape of the jaw angle determines the lower arc of the face shape side view; the outer degree of the jaw angle also affects the lower part width of the face. Therefore, the removal of the jaw angle is one of the important steps to improve the face shape; however, facial nerve and jaw angle is very close, unskilled surgical techniques may hurt the facial nerve, causing serious sequelae, so the choice of physicians is very important. Jaw angle is divided into two layers of internal and external bone layer, the middle of the bone marrow cavity, surgical methods also do not need to remove the jaw angle, and only remove the jaw angle outside bone layer, to retain the bone marrow cavity and internal bone layer; some people jaw angle is not particularly developed, hoping to keep the arc of the jaw angle, and want to reduce the width, can use this method. The distance between both side jaw bodies (that is, the width of the U-shape) determines the width of the lower face, but it cannot be changed. However, the jaw body is divided into two layers, the middle sandwiched bone marrow cavity, you can use the surgical method to remove the outer layer, for more space to reduce or change the curvature of the jaw body.
 
The chin is one of the very important elements of the face shape, although it belongs to the part of the jaw bone.
The distance between the two temporomandibular joint condyle (that is, the width of the both side temporal jaw joint) also affects the width of the face shape (which is different from the width of the head shape), which cannot be changed, and the place has been cover by hair sideburns, affect the visual effect of face shape is not large.
 
Zygomatic arch is an important factor affecting the width of face shape.

The jaw bone also has an important structure, that is, "chin nerve." From the inner side close to the upper part of the lower jaw bone through bone marrow cavity, along the bone marrow cavity all the way forward and supply the lower row of teeth perception, now, it is called "lower alveolar nerve". Until close to the canine it through the nerve hole again, into the lower lip, responsible for the lower lips perception, known as the "chin nerve." It is the most important culprit caused postoperative pain after surgery, surgery will often pull it, causing lips consciousness temporary numb; if the surgery hurt it, may cause permanent perception numbness. (This is the perception of nerve, not facial nerve kind of motor nerve, after the injury will only cause numbne
ss of consciousness, and different than facial nerve injury will cause the mouth crooked and eyes oblique.)
 
Dr. Roye Tsai
Dr. Roye Tsai Said...
Surgical method of removal of jaw angle
Surgical are divided into three methods, in addition to the first use only grinding method, the other two are with the grinding bone and cut bone method. There are two methods of oral and oral outside surgery, both pros and cons have been controversial, but the oral surgery has been very mature, oral outside surgery has been eliminated.
(illustration)
 
1.Grinding bone surgery
This operation does not remove the jaw angle, only the jaw angle and jaw body outer bone grind off, the thickness to grind off is limited, only up to 5 ~ 6mm,the improved effect is not obvious
Advantages: technology is simple, not easy to bleed
Disadvantages: limited effect
2. Angle Splint Osteotomy (ASO)
This operation also does not remove the jaw angle, with a knife method to remove the jaw angle and the outer body of the jaw body, retaining the bone marrow cavity and the inner bone layer, so also retained the original jaw arc; only reduce the thickness of the outer bone layer, change the magnitude is not big. In addition, because the inner bone layer is still there, the masticatory muscle still have skeleton support, masticatory muscle hypertrophy problem cannot be solved, so the improvement is usually not obvious, only suitable for a few people.
Advantages: to retain the original jaw arc, suitable for people who want to narrow the width and want to keep the jaw angle
Disadvantages: the improvement is limited, only the appropriate candidates have effect. Surgery using a chopper, the risk is still there, to choose the experienced physician because the incision of the bone marrow cavity, bleeding conditions need to control, there are coagulation dysfunction, anemia, or facial hemangioma are not suitable.
3. Angle resection
This surgery will remove the jaw angle, a greater range of change; and because the masticatory muscle loss of skeleton support will slowly shrink, but also partly solve the problem of masticatory muscle hypertrophy. Jaw angle incision position must avoid the bone marrow cavity in the lower alveolar nerve, it will not cause the numbness of the numbness of consciousness. And the curvature of the incision must be done with the chin to create a beautiful and coordinated jaw arc.
Advantages: significant changes in surgical range, part of the problem to solve masticatory muscle hypertrophy, jaw arc can be re-shaped.
Disadvantages: high technical difficulty, the existence of risk, to select the experienced physician, bone marrow cavity was cut, bleeding situation to be controlled, the surgery patient must be screened.
 
  • 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

At present the mainstream approach is that the lower jaw angle surgery, combined with grinding bone surgery to moderate reduction the lower jaw body, and create a good curvature. Sometimes with the chin, to make the appropriate length and width ratio, you can get very obvious visual effects. Chewing muscles do not remove; people with rich skin fat, may also consider liposuction surgery, otherwise the effect will be worse. Most people do simple bone surgery can get good results. Single grinding surgery, the effect is very limited, poor satisfaction. Surgical risk is there, the choice of experienced physicians is very important; physicians must also do a screening check, remove those who are not suitable for surgery, in order to avoid dangerous situations.

  •  
Dr. Roye Tsai
Dr. Roye Tsai Said...
Face shape sculpture is suitable for age
Although many young people have been very mature in appearance, but the actual physical or psychological maturity is not necessarily mature as the appearance, so need to set the objective criteria to distinguish between appropriate age for surgery:
 
• The age of facial bone developing mature is about 18 to 19 years old, so the operation age is at least older than 18 years old, then it will not affect the normal development.
•The large-scale plastic surgery of face-shaped sculpture requires not only mature physiologic, but also need enough mental maturity to undertake the pressure and impact of surgery, although 18 years old is already a mature age of facial bone development, still there are someone advocate late surgery is better, I think the best surgery age should be 22 to 25 years old, because the school has been completed, life is about to enter the workplace of the competition, it is the best time to change a beautiful new face , and no school and work restrictions, there is enough recovery time.
• To take surgery under the age of 20 should be approved by a legal representative, that is, must obtain parents’ approve to operate.
Dr. Roye Tsai
Dr. Roye Tsai Said...
Does cut bone pain hurt
Many people do not dare to surgery because of fear of pain, especially after the media exaggerated rendering, causing too many unnecessary anxiety, "fear of pain" is the biggest psychological barrier of the surgeon, in fact, worry too much, near the chin surgery will be pain, "Pain or no pain" is different because of person, and related to the surgical content:
 
Where is the difference between pain and no pain?
Bones does not have perception is not aware of the pain, face shape surgery caused by the pain of two:
1. Surgical wounds - limited to oral mucosa and a small number of facial skin, the feeling of pain is not high
2. Sensory nerve - mainly the under chin nerve, its position on both sides of the chin, near the back of the canine teeth, in charge of the lower lip and chin around the skin perception, the closer the surgery to the chin has the higher chance of pulling the nerve , and produce pain, the main pain is caused by this.
 
• which surgery will hurt?
The principle is that the closer the surgical position to the facial features:
Cheekbones surgery - because away from the facial features, almost no pain.
Jaw angle resection (without jaw body narrowing and chin shaping) - because it will not pull the nerve, nor too painful.
Jaw angle resection and jaw body narrowing (without chin shaping) - higher chance to pull the nerve, the pain is obvious.
Jaw angle resection surgery, jaw body narrowing, chin plastic surgery - the surgery chance of producing pain is high.
 
What are the pain-relieving methods? A big difference in pain sensitivity due to personal physical condition, the general practice is as follows:
1. Morphine drugs: This drug is given only after surgery and during hospitalization, usually only two days, by the medical staff injection or by the instrument control through the person with surgery to give their own, the analgesic effect is huge, but the side effects of dizziness and vomiting also often occurred, because the face shape surgery will almost all through the mouth, in order to avoid the risk of increased respiratory tract obstruction, it is not commonly used.
2. injection of non-steroidal pain drugs: this drug is also given during hospitalization, analgesic effect is small, but the use on face-shaped surgery analgesic effect is enough, will not lead to vomiting, relatively safe, usually used after the end of surgery, the next day can be replaced by oral drugs.
3. Oral non-steroidal pain drugs: most people need as long as 3 to 5 days of drugs, a small number of people does not even need drug to stop pain.
Dr. Roye Tsai
Dr. Roye Tsai Said...
Oral surgery or Outside?
Cheekbones and jaw bone surgery to choose oral and outside oral surgery, from the past to the present has been controversial, cheekbone surgery controversial is still large; jaw bone surgery has been certain as oral surgery, outside oral surgery should be eliminated.
 
Outside oral surgery
The biggest reason to choose oral surgery is to avoid the risk of intra-oral surgery, including: easy bleeding, surgical vision is too small, respiratory obstruction and so on, but the above problems have been overcome by technology. Many people think that outside oral surgery can avoid facial nerve injury, in fact, it is the wrong idea, in theory, the chance to hurt the facial nerve through the outside oral surgery is higher.
 
Oral surgery
The biggest reason for choosing an oral surgery is to avoid creating visible scars, but the difficulty of oral surgery is high, and physicians need to have professional training, which is the main reason that the past considered as high risk, as long as the physician take professional training then can overcome. Jaw bone surgery has been all changed to oral surgery, in addition to no visible scars, the view of surgical field even larger, can do the overall jaw bone sculpture and chin shaping, no longer just remove the jaw angle, the effect of surgery is good; cheekbone surgery is currently There are still oral surgery inside and outside the controversy, each with advantages and disadvantages, in principle:
• change the range of the larger demand for cheekbones surgery to choose oral and outside oral two ways to match.
• Change the size of the need for smaller zygomatic surgery to choose oral surgery will do.
Dr. Roye Tsai
Dr. Roye Tsai Said...
Possible sequelae
  • 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.
Dr. Roye Tsai
Dr. Roye Tsai Said...
The difference between face shape sculpture and orthodontic surgery
Both surgery is complex facial bone surgery, the operation with high technical difficulty, need professional surgeons to perform. In general, the main purpose for orthodontic surgery is to rebuild the occlusal function, but also have the function to improve the beauty of mouth shape; face sculpture is a cosmetic surgery, do not involve bite function therapy, the purpose is to change the face shape.
 
Orthodontic surgery Orthodontic surgery
Face Sculpture Surgery Face Sculpture Surgery

 
 Orthodontic surgeryFace Sculpture Surgery
Surgical purposesTo correct bad teeth, reconstruction of occlusal function. Improve the gums exposed, buck-tooth, bucket. Non-surgical orthodontics can begin at the age of 8.Improve bad face shape, is cosmetic surgery.
Surgical rangeUpper and lower jaw bone and dental archjaw bone, chin, forehead, eye brow
Treatment of orthodonticsDentistry for Diagnosis and Tooth Making Design, Oral surgical or Orthopedic surgical perform surgeryOrthopedic surgical
Surgery Ageover 18 years of ageover 18 years of age
Recovery time3 to 6 months
In addition of Surgery, the need for 1 to 2 years of dental correction treatment.
3 to 6 months
Applicable to the objectgingival exposed, buck-tooth, bucketsquare face, square face, chin too long or too short, high cheekbones, cheekbones wide, high eye brow, forehead bone depression and so on
Preoperative precautions
Before surgery, please look at the following contents and explain, mark the unclear place, and communicate with the physician at the clinic.
 
一、Preoperative precautions
  • The clinic accept scheduled surgery date three months in advance, and is retained until the last week for the final confirm, If the clinic is unable to confirm for the time being, the clinic may transfer the scheduled date to another surgery patient.
  • Surgical X-ray and physical examination should be completed one week in advance, the most urgent need three days to complete. (This clinic must accept the medical report of other medical institutions, must be within three months, and meet the requirements of surgical examination items.
  • X-ray and physical examination results will be informed by telephone to the surgery patient, meets the surgical safety standards then can confirm the operation; does not meet the standard, it is recommended to give up surgery, or to suspend surgery. Re-test after three months, if still does not meet the standard, it is recommended to give up surgery.
  • Try to relax and stay physically before surgery, stop all noninvasive drug intake, including diet pills, anticoagulant drugs or traditional Chinese medicine, and nutritional supplements for unknown ingredients.
  • One day before the operation, the clinic will interview by telephone to remind the anesthesia before the note, and do the surgery final confirmation.
  • Surgery patient should arrange at least one week after surgery necessities of life,  avoid inconvenient going out after postoperative swelling. (For facial bone surgery to be prepared with liquid food and children's toothbrush)
  • Do not drive yourself on the day of anesthesia. Please arrange for family or friends for transfer, or the clinic will arrange for transportation.
  • Remember to carry sunglasses, hats, masks or scarves when perform a facial surgery, convenient for cover when return home, to avoid embarrassment.
 
二、Take the initiative to inform the physician whether the abnormal physiological condition or disease, including:
□  Is there a cardiovascular disease (e.g. arrhythmia)?
□  Is there abnormal bleeding (e.g. bleeding)?
□  Are there facial vascular abnormalities (e.g. hemangioma)?
□  Are there facial nerve dysfunction, or facial expression abnormalities?
□  Is there any drug allergy or other allergies?
□  Are there infectious diseases (such as hepatitis C, AIDS, tuberculosis)?
□  Have you took any other surgery?
□  Are there foreign bodies implanted in the body?
□  Is there an adverse anesthesia response record (including other family members)?
□  Is there any other major disease or genetic disease?
 
三、The need for facial bone surgery to complete the following preoperative examination items

A. X-ray photography:
  • P-A View
  • Cephalometric View
  • Panoramic View
B. Physical examination:
  1. Electrocardiogram (EKG)
  2. Blood test
  • General blood test (CBC routine)
  • Prothrombin Time (PT)
  • APTT
  • Blood type
  • Rh factor
  • Glucose AC
  • Cholesterol
  • Liver function (GOT / GPT or AST / ALT)
  • Renal function (BUN, Creatinine)
  • Hepatitis B (HBsAg)
C. Urine examination
Osteotomy (Patient Instructions)
Before surgery
  • See preoperative precautions
  • Communicate the expected results with the physician• Preoperative examination of preparation: blood, electrocardiogram and X-ray.
  • 8 hours before surgery, fasting, water-deprivation (tea, coffee, etc.)
  • Preoperative photography
  • take the initiative to inform the physician whether the abnormal physiological condition or disease 
Surgery day
  • Do not ride on your own
  • 1 to 2 nights stay in the hospital
  • Waked up after anesthesia will be given the injection type of pain relieve medication to reduce the pain of the wound; after eating the next day, change to oral pain medication, for 3 to 5 days.
  • (After jaw angle surgical removal, the wound bleeding situation is more obvious, need to install the drainage tube, drained out the residual blood in the body to avoid hematoma production, after surgery removal the next day. 
After surgery
  • After surgery the next day can begin eating fresh liquid food and start using prophylactic oral antibiotics for 5 to 7 days.
  • Always rinse with boiled water to keep your mouth clean; use a mouthwash after eating to avoid wound infection.
  • Continuous ice for at least 3 days, after that you can change to hot compress.
  • If the mouth is slightly scratched around the mouth, keep it clean with water and wipe the ointment.
  • Can wash face, also can bathe and wash hair, cannot use hot water.
  • One month after surgery, the face cannot be forced to massage, to avoid bleeding also reduce the sequelae of loose skin sag. If the bleeding occurs immediately press the wound to stop bleeding and ice, after 15 minutes it should stop by itself, if still cannot stop bleeding continue to press the wound, and immediately seek medical attention.
 
Postoperative recovery
Zygomatic surgery pain is very mild, jaw bone surgery pain is more obvious, the more close to the chin more obvious, this is because the mandibular nerve pass through so; swelling is the physiological response any surgery will happen, the main stages include: bleeding (initial) , Inflammation (mid-term), and lymphatic circulation block (late), swelling and bruising degree varies from person to person, most people are as follows:
  • Day 1 to 3 days
  • Wound bleeding still slowly continues, so the wound will become more swollen, blood stasis will become more and more obvious, most people will feel fear, in fact, this is normal, and therefore the wound need to use elastic bandages, and continue ice, to keep up the posture, to rest completely.
  •  
  • Day 3 to 4 days
  • Bleeding phenomenon is stopped, is the most swollen time, but also the most obvious of the bloody inflammation, inflammation reaction began to increase, the feeling of swelling of the wound becomes obvious, but the pain continue to reduce.
  •  
  • Day 5 to 6 days
  • Swelling peak has passed, began to show signs of swelling, bruising also began to fade yellow, but the color is still obvious.
  •  
  • Day 7 to 10 days
  • There is a close observation of wound inflammation: the normal situation of the wound is no longer pain, persistent eliminate swelling, bruising may have been disappeared, regain clear speak, if the wound suddenly swollen, become more painful, redness, meaning there is inflammation phenomenon, the need for medical diagnosis and treatment, so this is usually the first time back to the clinic after surgery
  •  
  • Day 10 to 14 days
  • Swelling has been eliminated more than 50%, bruising has also been disappear completed, leaving only some yellow ecchymosis on the neck, it is the time able to go out, also can resume to work, but still can see the face swelling; some people will find a goodwill lie to explain to avoid interpersonal embarrassment.
  •  
  • 2 weeks to 1 month after surgery
  • Eliminating swelling slows down, it is because the inflammatory reaction has been transformed into a reorganization stage, the change is very slow, this is the most important time to prevent skin relaxation and help skin tightening, no massage, it is best to continue to use supportive elastic bandages, help skin shaping.
  •  
  • 1 to 2 months after surgery
  • Wound reorganization continues, the lymph circulation has not yet been re-established, so the swelling situation becomes ups and downs, and will change with the amount of water intake and the height of the body posture changes, can use hand lightly press to help eliminating swelling, cannot use rubbing, most of these phenomena can be ignored, will naturally recede, this is the time when the surgical effect gradually show up, so wait with patient.
  •  
  • 2 to 6 months postoperative
  • Postoperative wound reorganization of the physiological period is 3 to 6 months, including skin tightening and bone regeneration, etc., it is recommended to avoid eating hard food at least six months to help bone healing, but also to prevent bone regeneration, in addition to the establishment of lymph circulation also need several months’ time to complete, during this time the wound changes very little, but still the swelling gradually eliminate, feeling like more and more thin, so the final fixed time of face is 6 months.
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Add:5F., No.107, Sec. 4, RenAi Rd., Taipei, Taiwan

Tel:02-2772-8887 Fax:0227725822
Wechat ID:miniface_info LINE ID:@vyl7873s

Miniface have no counselors, reply letters by the physician himself, please forgive me if the reply letter late, in general, reply time of 2 to 7 days, no patient to wait for the appointment of outpatient consultation.
Online consultant please provide the following photos: No makeup positive photo / left side 45 degrees / left side 90 degrees / right side 45 degrees / right side 90 degrees
Suggestions to add photos: makeup photo / whole body of life photos
Miniface no consultants, all professional issues answered by the physician personally. Friends or relatives can participate in the consultation, in order to maintain the quality of consultation, do not exceed three person. For special personal privacy needs, please inform the physician first. Can carry information or photos for the physician reference, discuss. The initial cost of five hundred dollars, can be deducted from the surgery fee.
Before the appointment of surgery by physician assessment, consultation method: (1) consultation physician mailbox (2) appointment outpatient consultation.
Please read the preoperative instructions and check items before surgery. After payment of the deposit, we will reserve your scheduled date of operation. "The surgical procedure need physicians with a high degree of focus and commitment, every day of surgery, every physician, only a large amount of surgery, for you to go all out." - is a micro-mini insistence. If you have any reasons need to change the date of operation, please call one day before the operation, otherwise the deposit is not refundable, please be understandable.
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