The rich get richer, the poor get poorer

The facial contouring and double jaw surgeries I specialize in involve handling the frame inside the face. The basic framework of the face is shaped to change the shape of the face on the exterior. 

For the facial bone surgery I perform to manifest on the outside, the soft tissue covering the frame needs to reflect the change in facial bones. Accordingly, the better extent to which soft tissue reflects, the better the results of surgery. The main constituents of soft tissue consist of the outer skin, subcutaneous fat, and muscles. As we generally see the skin looking from the exterior, I will refer to soft tissue as skin from hereon.

The results of facial bone surgery reflect well if skin meets two conditions.   

First, it must be thin. More accurately, thin subcutaneous fat. If this is thick, even if bone surgery changes the frame, less degree of change is reflected on the outside. If I were to compare this with a sculpture, it would be as though a thick winter blanket was covering a delicately sculpted sculpture. Basically, those with little facial fat (skin coming into contact with bones so to say) are a good candidate for bone surgery.  

Second, skin must have good elasticity. The bone surgery I perform generally reduces the volume of facial bones (to make the face smaller). If there is little skin elasticity, skin will be unable to bear the reduced bulk and sag instead. Again, if I were to make a comparison, it would be like wrinkles forming when saran wrap is put over something or food and not pulled taut. Pulling it to wrap it tightly will makes whatever is wrapped look far better. We generally call skin taut if it has good elasticity. Rather than feeling flabby, slightly firmer feeling skin is ideal. Skin that looks clean without any blemishes and very soft skin look good at first sight but this is ordinarily called mushy skin, lacking elasticity considerably, and is prone to appear saggy after bone surgery. As skin elasticity diminishes with age, this makes older skin less suitable for bone surgery. Pre-surgery elasticity is important, depending on the elasticity of the skin you’re born with as well as your age and how well it has been maintained.  

To conclude, bone surgery has good effect on skin that is thin with good elasticity. But if you think about it carefully, there is a high likelihood that those with such skin condition started out more attractive than those without even before surgery. This is to say that those who were pretty to begin with will likely see better results, and the sad truth is that the rich get richer and the poor get poorer even in plastic surgery.

However, in order to improve such unfortunate situation (rich get richer, poor get poorer), various procedures and surgeries are being developed to improve elasticity and make skin thinner, and are seeing results to a certain extent. This is one of the areas that is being researched most actively at the time with new attempts continuing to be made. I will continue to strive to improve this ‘rich get richer’ phenomenon.  

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