Functional and Aesthetic Surgery of the Facial Skeleton

Cirugía Funcional y Estética del Esqueleto Facial


“The facial skeleton defines the proportions of the face, soft tissues define the facial contour”


Profile correction procedures deal with changes in the projection of prominent areas of the facial skeleton as forehead, nose, cheekbone (malar bone) and chin. Profile correction may be required by augmentative or reductive measures. The entire forward or backward movement of the facial skeleton as the upper jaw, lower jaw, but also chin, cheekbone and orbit is possible. The nose is an independent unit that can be corrected by an open or a closed approach (see Aesthetic plastic surgery of the face). The chin correction (sliding genioplasty) allows forward or backward movement and is often combined with rhinoplasty. The art of a natural and outstanding result is the holistic consideration of the proportions of the face.


Signs, Symptoms and Treatment (Common description vs. Medical description)

  • Skull

    · Signs and symptoms: Cranial asymmetry, skull defect 

    · Treatment: Modeling (reduction or augmentation), cements or individual implant for full-thickness defect;  Medical descriptionSkull augmentation (biomaterials) or reconstruction with individual implants (PEEK).

  • Eye socket/ Orbit

    · Signs and symptoms:  Congenital or acquired condition (trauma or tumor), eyeballs that stick out in patients suffering hyperthyroidism; Medical descriptionHypoplastic orbit, enophthalmus, exophthalmus, diplopia (congenital, traumatic or tumor),  Graves’ disease (exophthalmus).

    · Treatment:  Eye socket correction, eye fat reduction; Medical description: Bone grafts, osteotomies, orbital decompression acc. to Olivari in Graves’ Disease.

  • Cheekbone/ Malar bone

    · Signs and symptoms: Congenital malformation, acquired defect; Medical descriptionAgenesis (Franceschetti syndrome), defects after tumor or trauma.

    · Treatment: Bone grafting, soft tissue augmentation (fat injection); Medical description: Bone grafting, distraction osteogenesis, micro fat transfer.

  • Upper jaw /Maxilla

    · Signs and symptoms: Dish face, long face; Medical description: Retromaxillism, Antemaxillism.

    · Treatment: Forward, backward and/or vertical movement; Medical description: Lefort I, II, III osteotomy, distraction osteogenesis.

  • Jaw/ Mandible

    · Signs and symptoms: Dish face, long face;  Medical descriptionPrognathism, antemandibulism, micromandibulism, micrognathia.

    · Treatment: Forward or backward movement; Medical descriptionSagittal split osteotomy acc. to Obwegeser-Dalpont, distraction osteogenesis (internal devises).

  • Chin

    · Signs and symptoms: Long chin, short chin, protruding chin, receding chin; Medical description: Hypergenia, hypogenia.

    · Treatment: Chin surgery; Medical description: Increase or reduce the chin length and projection through a intra-oral approach (no skin incision),  Sliding genioplasty (osseous genioplasy) through a trans-gingival (sulcular) approach (no skin incision), distraction osteogenesis in extreme chin deficiency.