Most plastic surgeons are trained to look at a face from the front and make their assessment and recommendations based on this one angle. And when they look in the mirror, many facial plastic surgery patients in Toronto do the same thing.
Although we all know that the frontal view is the most important, one should not forget that the profile and the ¾ views are almost equally important, especially in this digital era of selfies.
The concept of “profiloplastia,” or the aesthetic study of one’s profile appearance, arose in South America, a place where I commonly attend conferences to get inspired for my plastic surgery work. We all know Brazilians, Colombians, and Venezuelans are quite enamored with beauty…and so are Americans and Canadians.
AGING is synonymous with jowls, the sagging of the cheeks, the sagging of the eyebrows, the elongation of the upper lips, the loss of volume in lips, cheeks and periorbital region, the hair loss and receding hairline, etc. This is what one sees on the front view.
But there is so much more that can be done for a better profile that we often don’t pay attention to.
Chin augmentation is an important player in the profiloplasty as it helps restore harmony with the nose. It also helps camouflaging the jowls and will make both a neck lift and facelift look better…and for a longer period of time. Remember, we lose volume in fat, bone and muscle as we get older, not to mention those who are born with a “weaker” chin. Chin augmentation can be done with an implant (we have 13 different models, all coming in 5 sizes so 65 options!!!) or with our longer-lasting hyaluronic fillers.
The upper lip also deflates and hang down over time so the Italian or my modified bullhorn lip lift with address this small but so important factor of aging. Adding a natural-looking amount of volume to them is also important.
The nose goes without saying. A rhinoplasty can make a nose stronger or smaller, in order to complement the face better. To this, I would add our mid-face implant that will convert a concave face (commonly referred as “dish face,” in profile) into a more balanced face. Therefore, mid-face implant will correct for an underdevelopment of the nasal-maxillary regions. Fillers can also be used in the mid-face and on the nose, the so-called nonsurgical rhinoplasty. And I always perform it with my cannula technique.
Temples. Hollow temples are associated with aging, terminal diseases and with some immunodeficiency conditions. Temporal implants are simple procedures with high rewards in my rejuvenation ladder of options, along with fillers and fat grafting, so no more “peanut head.”
Foreheads should be square, flat and angular for a man… but totally the opposite for ladies. In women, we want a short forehead, smooth and convex. Adding fillers or fat, or a custom-made implant helps to restore youthfulness in the forehead region.
Hairline can be modified too. Various scalp flaps (rotation and advancement of hair-bearing skin tissues) along with hair transplants are important tools for a plastic surgeon, including the addition of PRP (platelet-rich plasma).
Jaw angle implants, for men of course but also for the ladies who like the Angelina Jolie’s square jawline, are very important when addressing lights and shadows in one’s profile. Jaw angles can widen the angles and elongate the jaw angle for a squarer look in rounder faces.
Talking about round faces, buccal fat pad removal is a great adjunct to chin implant and jaw angle augmentation. It is a simple procedure with great enhancing potential.
Fat grafting is always considered, especially when someone is undergoing a neck lift or facelift; fat grafting is commonly done to temples, forehead (younger feminine forehead is rounder), upper and lower orbital area, cheeks, mid-face, lips, jawline, chin, marionettes, laugh lines, etc.
Finally, the often forgotten one, the earlobe. Earlobes get stretched over time and deflate, with or without the wear of earrings or gauging loops. Earlobes can be repaired, made smaller, can be augmented and filled, etc. Earlobes are often rejuvenated during a facelift and neck lift procedure.
As you see, profiloplasty is a lot more than a traditional facelift and neck lift, hence also the importance to meet a surgeon and not a “delegate” when considering such as complex but rewarding procedure.
Make sure your plastic surgeon looks at you on every angle and that all options are discussed.
Dr. Marc DuPéré