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It is the analysis of a face which makes it possible as well as possible to appreciate the balance of the various structures between them and harmonizes it of the unit. The face (upper floor), the nose (average stage), the lips and the chin (lower stage) obey reports of precise proportion.
The study of the profile starting from photographic and radiological documents constitutes a complementary element which will help to define the surgical gesture best adapted. Thus a rhinoplasty withdrawing a bump, can appear insufficient if a very reducing chin is not also corrected.
In the same way, a nose can appear a little small whereas it is the chin which is too projecting. The correction of the chin can also be indicated according to whether it is a question (mention ahead) or of a (receding chin). The relief of the knobs is also studied, because it takes part in this architecture of the face.
The study of the relative proportions can thus in certain cases result in advising a surgical complement for a better physical balance of the face: it is the .

There exist multiple cases or a can be indicated.
On the level of the nose, it is a question of correcting a bump or on the contrary an insufficiency of projection.
The chin, important component of the aspect can, by an unbalance on its level to involve a too discrete or unobtrusive aspect or on the contrary too aggressive of the face.
The makes it possible to harmonize the projection of the chin.
As for the relief of the knobs, it can in certain cases insufficient being because of an incomplete development of the zygomatic bone.
A lengthwise face is then judged like not very expressive.
These different can coexist with variable degrees and justify an adapted intervention.
It is within the framework of a consultation that each one of these elements, noses, chin and knobs will be studied.
This type of operation, which is practiced as well at the man as at the woman, can be under consideration from 16 to 18 years.

The first consultation is fundamental because it makes it possible to determine the motivations well and to lay down precise objectives.
The medical history and surgical is referred to (allergies and medicamentous capture…). The family history and hereditary is specified.
The analysis of the face thus makes it possible to define the surgical possibilities as well as possible and to specify the precise problem to correct.
A detailed explanation is given to the patient and the consultation contains the capture of photographs, useful for the operational evaluation.

A consultation with the doctor-anesthetist is programmed before the intervention to practice a complete physical exam and to prescribe the complementary examinations necessary.
This consultation makes it possible to refer to the various types of anesthesia and to take all the safety measures necessary.

Which type of anesthesia is practiced?
Generally an intravenous general anesthesia is indicated, because these various lesions frequently coexist.
An intervention of the chin can be practiced under neurolept-analgesia, an intervention of the knobs requires an general anesthesia on the other hand. It is the same for an esthetic rhinoplasty.
The mode of anesthesia is studied according to each typical example and of the degree of anxiety of the patient.

Which is the duration of the intervention?
A , plastic surgeon of the chin in general lasts 1 hour.
It is the same for an intervention of the knobs.
When with a surgery of rhinoplasty, this intervention can be a little longer because of the more complex structure of the nose.

Will there be visible cicatrices?
For a , the cicatrice is endo-oral, on the level of the mucous membrane, and it is completely invisible.
For the increase in the knobs, it is the same, the cicatrice being made inside the mouth.
A rhinoplasty contains invisible or very discrete cicatrices in general.

How is held the intervention?
The cosmetic surgery of the nose or rhinoplasty is the subject of a full description in a special chapter. Generally, the cartilage is refined and the osseous bump is reduced.
The intervention was carried out by channel and there is in general no visible cicatrice.
In certain cases, one can reduce the width of the nostrils.
The esthetic rhinoplasty is a field or the most important progress was recently carried out, allowing as well rhinoplasties of reduction (bump) that rhinoplasties of increase (gristly grafts) to correct a nose subsided, impressed, or insufficiently projected.

On the level of the chin:
- When the chin is reducing , two techniques are possible:

• that is to say the installation of a prosthetic silicone implant, generally,
• that is to say the use of an osseous rod taken on the chin and laid out ahead (in this case, a general anesthesia is made).

The choice of one or the other method, depends on the specific anatomical conditions and the decision is made after complete information of the patient. Enough frequently, a by accumulation of grease is associated and corrected by a carried out in same time.

When the chin is projecting , the intervention is carried out under anesthesia of the general type and lasts 1 hour. The technique consists in withdrawing by endo-oral channel, a surplus rod osseous, which involves a retreat of the chin and a better balance of the line of the profile.

With regard to the knobs, it is generally a prosthetic silicone implant which is set up by endo-oral channel.
The size, the form and the relief of the implant are as a preliminary defined by a morphological analysis, and this implant which is affixed on the osseous relief (zygomatic and ) makes it possible to obtain desired projection.
This type of operation can be carried out separately or at the time of any other intervention of the face such as for example the cervico-facial face lift or mask-top spin, contributing to improve the negotiable instrument of renovation.

Which type of bandage will be used?
In the event of rhinoplasty, a plaster is set up during 8 days.
In the event of (chin), a bandage slightly compressive and modelling, is implemented to the operated area. At the level of the knobs, a compression bandage and modelling is set up.

Which is the duration of the hospitalization?
In the event of rhinoplasty integrating an intervention of the nose, chin and knobs, the duration of the hospitalization is 48 hours. 24 hours are enough in general for an isolated intervention standard chin or knobs.

In the operational continuations, there exists, obviously, a facial edema which appears in the 48 hours which follow the operation and which persists about 8 days.
It attenuates gradually under the negotiable instrument of an adapted processing.
The result is in general visible 15 days after the operation.
It is as from this moment, that a resumption of the occupation is possible.
The activity of the sporting type is possible nth after the operation.

Like any surgical operation, some rare complications are possible such as: infection, hematoma, or an anesthetic complication.
On the esthetic level, an imperfection can exist on the level it nose and require a later rework generally carried out under local anesthesia.
On the level of the chin, the intervention is in general extremely satisfactory, in rare case, an infection can force with the ablation of the implant. The cicatrization is then carried out in a spontaneous way.
On the level of the knobs, an asymmetry can exist just as an asymmetrical edema can occur.
This type of disadvantages can require a surgical reintervention. An infection is also possible, forcing then with the ablation of the implant.
A regular monitoring allows to detect a possible complication as well as possible and to discuss it as soon as possible.

Once the withdrawn bandage, he is advised to carry out an anti-ecchymotic and processing.
Possibly, some massages are useful to accelerate the resorption of the edema.
Consultings are given to avoid an involuntary traumatism and the sports practice must be deferred during nth.

When the implants are well tolerated, that it is about silicone for the chin, the knobs or of another product, or that it is about cartilage, there is a long-term stability of the result.
It is not therefore advisable to provide for other operations of this type.

These various operations, rhinoplasty, chin and knobs, belong to an comprehensive analysis and morphological face.
The study of the relative proportions can thus in certain cases result in advising a surgical complement for a better physical balance of the face.
It is the objective of the .