Skip to main content
Log in

Bone expansion in facial rejuvenation

  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Soft tissues and bone structures of the face are both affected by aging, but the bone is the more important element in the three-dimensional contour and suspension of the soft tissue. Bone expansion augments bone volume in the midface. A lamellar split osteotomy of the midface is used for bone expansion, and cranial bone grafts fill spaces created by the expansion. These grafts, which resorb less than onlay grafts located on the resorption zones, are placed in contact with the apposition zone. This technique changes the three-dimensional contour of the outer lamella of the midface while maintaining its morphology. Bone expansion restores bone mass lost to resorption. It is performed along with a facelift. Yielding a face with a younger appearance, not just a face with less wrinkles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Artz JS, Dinner MI, Foglietti MA: Planning the aesthetic forehead plasty. Ann Plast Surg 25:1, 1990

    Google Scholar 

  2. Bell WH, Proffit WR, White RP: Surgical Corrections of Dentofacial deformities. Philadelphia: W.B. Saunders, 1980

    Google Scholar 

  3. Binder W.J.: Submalar augmentation: a procedure to enhance rhytidectomy. Ann Plast Surg 24:200, 1990

    Google Scholar 

  4. Block MS, Zide MF, Kurt JN: Proplast augmentation for post-traumatic zygomatic deficiency. Oral Surg 57:123, 1984

    Google Scholar 

  5. Conley JS: Complications of Head and Neck Surgery. Philadelphia: W.B. Saunders, 1979, pp 378–380

    Google Scholar 

  6. Converse JM, Wood-Smith D: Horizontal osteotomy of the mandible. Plast Reconstr Surg 34:464, 1964

    Google Scholar 

  7. Enlow DH: The Handbook of Facial Growth. Philadelphia: W.B. Saunders, 1982

    Google Scholar 

  8. Epker BN, Wolford LM: Middle-third facial osteotomies: their use in correction of acquired and developmental dentofacial and craniofacial deformities. J Oral Surg 33:491, 1975

    Google Scholar 

  9. Freihofer HP, Borstlap WA: Reconstruction of the zygomatic area: a comparison between osteotomy and onlay techniques. J Craniomax Fac Surg 17:243, 1989

    Google Scholar 

  10. Friedland JA, Coccaro PJ, Converse JM: Retrospective cephalometric analysis of mandibular bone absorption under silicone rubber chin implants. Plast Reconstr Surg 57:144, 1976

    Google Scholar 

  11. Gonzalez-Ulloa M: Building out the malar prominences as an addition to rhytidectomy. Plast Reconstr Surg 53:293, 1974

    Google Scholar 

  12. Hinderer UT: Nasal base, maxillary and infraorbital implants-alloplastic. Clin Plast Surg 18:87, 1991

    Google Scholar 

  13. Hinds EC, Kent JN: Genioplastic: the versatility of the horizontal osteotomy. J Oral Surg 27:690, 1969

    Google Scholar 

  14. Mladick RA: Alloplastic cheek augmentation. Clin Plast Surg 18:29, 1991

    Google Scholar 

  15. Ousterhout DK: Aesthetic Contouring of the Craniofacial Skeleton. Boston: Little Brown, 1991, p 348

    Google Scholar 

  16. Powell NB, Riley RW, Laub DR: A new approach to evaluation and surgery of the malar complex. Ann Plast Surg 20:3, 1988

    Google Scholar 

  17. Psillakis JM, Rumley TO, Camargos A: Subperiosteal approach as an improved concept for correction of the aging face. Plast Reconstr Surg 82:383, 1988

    Google Scholar 

  18. Robinson M: Bone resorption under plastic chin implants: follow-up of a preliminary report. Arch Otolaryngol 95:301, 1972

    Google Scholar 

  19. Salyer KE, Taylor DP: Bone grafts in craniofacial surgery. Clin Plast Surg 14:27, 1987

    Google Scholar 

  20. Salyer KE: Lamellar split osteotomy: a new craniofacial technique. Plast Reconstr Surg 86:845, 1990

    Google Scholar 

  21. Tessier P: Autogenous bone grafts taken from the calvarium for facial and cranial applications. Clin Plast Surg 9:531, 1982

    Google Scholar 

  22. Tessier P: Subperiosteal face lift. Ann Chir Plast Esthet 34:193, 1989

    Google Scholar 

  23. Trauner R, Obwegeser HL: The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty: part I. Surgical procedure to correct mandibular prognathism and reshaping the chin. Oral Surg 10:677, 1957

    Google Scholar 

  24. Waite PD, Matukas VJ: Zygomatic augmentation with hydroxyapatite: a preliminary report. J Oral Maxillofac Surg 44:349, 1986

    Google Scholar 

  25. Whitaker LA: Facial skeletal contouring for aesthetic purposes. Plast Reconstr Surg 69:245, 1982

    Google Scholar 

  26. Whitaker LA, Bartlett SP: Aesthetic surgery of the facial skeleton. Persp Plast Surg 2:23, 1988

    Google Scholar 

  27. Whitaker LA: Temporal and malar-zygomatic reduction and augmentation. Clin Plast Surg 18:55, 1991

    Google Scholar 

  28. Whitaker LA: Skeletal alterations as a basis for facial rejuvenation. Clin Plast Surg 18:197, 1991

    Google Scholar 

  29. Whitaker LA: Aesthetic surgery of the facial skeleton. Instructional Courses 4:61, 1991

    Google Scholar 

  30. Wilkinson TS: Complications in aesthetic malar augmentation. Plast Reconstr Surg 71:643, 1983

    Google Scholar 

  31. Wolfe SA: Malar augmentation using autogenous materials. Clin Plast Surg 18:39, 1991

    Google Scholar 

  32. Zins JE, Whitaker LA: Membranous versus endochondral bone: implications for craniofacial reconstruction. Plast Reconstr Surg 72:778, 1983

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vicuña, R.G., Giottonini, A.S. Bone expansion in facial rejuvenation. Aesth. Plast. Surg. 18, 85–90 (1994). https://doi.org/10.1007/BF00444254

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00444254

Key words

Navigation