Hearing the term plastic surgery or plastic surgery, surely you immediately associate it with the process of changing certain body parts to make them look more attractive. In fact, the branch of plastic surgery medicine has a wider scope, and even includes the function of reconstruction to repair damaged body shapes.
Plastic surgery itself is a branch of medicine that focuses on repairing body tissue or skin that is damaged or deformed due to certain conditions, such as burns, accidents, tumors, and congenital diseases. In addition to repairing a damaged or deformed body shape, plastic surgery is also often performed to change body parts to make them look more attractive (aesthetic needs).
Having a perfect face shape is a dream not only for women, even men are willing to spend a lot of money to get a face shape that can increase their confidence. Which parts of the face can be improved to enhance appearance?
The perfect facial appearance of Indonesian and world celebrities is often a reference for people, especially women, so that they appear more confident. Even though everyone's beauty standards are different, there are still some women who are willing to spend a lot of money to improve the contours of their faces which they consider imperfect.
According to some plastic surgeons in Indonesia, the ideal face has the following structure:
- The length of the face is equivalent to 3 times the length of the nose
- The width of one eye is equal to the width of the distance between the two eyes
- The upper lip and lower lip are the same width
- Symmetrical eyebrows according to the nose line
- The width between the line below the eye and the line above the eye, is the same as the width between the line above the eye and the eyebrow
- The base of the eyebrow is in line with the inner corner of the eye (near the nose)
- The width of the face (across the cheeks) is 2 times the length of the nose
But is that a benchmark that those who have the ideal face are classified as beautiful? Not necessarily either. According to a plastic surgeon in Indonesia, beauty is not always based on a perfect face shape. “Facial harmonization does not have to be a measure of how beautiful a person is. A beautiful face doesn't have to have a sharp nose, round eyes, full lips or a long chin. Pug people can also look beautiful. That's everyone's perception. As long as the person is comfortable with their appearance, then it really doesn't matter."
FACE SECTION
Nevertheless, there are indeed some parts of the face that can be changed through plastic surgery procedures in order to enhance one's appearance. Some of the plastic surgery procedures that are often performed by people are as follows:
- NOSE
Nose surgery ( rhinoplasty ) is a plastic surgery procedure to correct or change the shape of the nose. Nose surgery is performed to change the size of the nose, either reducing the size ( nose reduction ) or increasing the size ( nose augmentation ), changing the shape at the base or tip of the nose, changing the angle between the nose and upper lip, correcting the shape of the nose caused by birth defects or injuries. Or it could also help improve breathing problems. The ideal nose shape varies from person to person. "A nose that is too sharp is also not good. A beautiful nose is one that is sufficient, not too high, not too small but harmonious with our facial composition," said a plastic surgeon in Indonesia.
Ideal Nose
However, when talking about an ideal nose, according to a plastic surgeon in Indonesia, he explained that the ideal nose is a harmonious nose seen from the front and side views. Seen from the front view, the width of the nose is approximately the same as the width of one eye. While looking from the side, usually the length of the nose is a third of the length of the face. Meanwhile for the ideal nose height, for women, the angle from the forehead to the nose bridge is 100-110 and for men it is around 115-135. While the angle between the collumela and the philturm and the lips for women is 90-95 and for men it is 95-106. "If you aim to elevate your nose by placing implants, there is art in everything. For women, it is placed after the indentation below the forehead, do not fit in the crook of the nose so that it does not look like an avatar," said one plastic surgeon in Indonesia.
Doing a rhinoplasty or other surgical procedure can be likened to sewing, a plastic surgeon is a tailor and the patient is the material. "If the material is small, don't ask for a big shirt or ask for a dress instead of making trousers," he said, who always gives this analogy to patients to make it easier for patients to understand the purpose of the operation. Likewise with the nose. If it's already sharp, don't add it to the implant. “It could be that the nose is already sharp but because of the large tip or tip of the nose, it does not look sharp. So what is fixed is the tip," he explained again.
Operation Procedure
There are several things that patients must do before undergoing a rhinoplasty procedure. Consult with a plastic surgeon to discuss the reasons and goals you want to achieve through rhinoplasty. “It must match the expectations of the patient and the doctor. The doctor will explain in detail the benefits that can be obtained as well as the risks and complications that may occur after rhinoplasty," he explained again. In addition, an examination will include a medical history examination, physical examination, and support, as well as a photo of the patient's face as data on the shape of the nose before surgery. Patients are also asked to avoid taking blood-thinning drugs such as vitamin E, avoid taking pain relievers that contain ibuprofen or aspirin, for two weeks before and after surgery.
The first surgical procedure performed is anesthesia, either using local anesthesia or general anesthesia or general anesthesia. Rhinoplasty can be done with two methods of surgery, namely closed surgery and open surgery. In closed surgery, an incision is made inside the nose. While in open surgery, an incision is made on the outside of the nasal septum which is close to the lips. Then the doctor will reshape the nose structure. This stage is carried out on the cartilage in the septum (the partition between the nostrils). If the nose is too large, the surgeon will remove some of the bone or cartilage by scraping the bone. Meanwhile, if the nose is too small, a cartilage grafting procedure or implant will be performed. If the patient has a crooked or improperly centered septum, the surgeon will realign it.
After surgery, there are several things that patients need to do during the healing process to reduce bleeding and swelling, for example, avoid strenuous activities such as jogging or aerobics, at least for 4-6 weeks, avoid smiling or laughing facial expressions, take a shower carefully To prevent water from getting on the nose bandage, avoid wearing T-shirts, sweaters, or other clothing that must fall over your head. Use a button-down shirt to avoid touching your nose. Complications that may occur after rhinoplasty include infection, tilted nose position, broken blood vessels. "Avoid pressing your face like sleeping on your stomach," he advises.
- EYELID
As the saying goes, eyes are the windows to the heart. According to another plastic surgeon in Indonesia, this is in accordance with the role of eye aesthetics in reflecting one's essential attractiveness. " Aging eye which is characterized by drooping eyelids and the formation of eye bags sometimes makes a person always look tired and sleep deprived," he explained.
Everyone's ideal eye shape is different and is very subjective. In the past, the Caucasian eye shape had become a trend where the Asian race wanted large eyelids like the Caucasian race. However, the current trend is more to suit Asian characters where the double eyelid remains the favorite choice but is made not too big. "The ideal eye composition varies for each race, both the Caucasian and Asian races. There is a calculation of the proportion of the eye which is the standard statistical average according to the standards of each race," he explained again.
Ideal Eye
Beautiful and attractive it really depends on the perception of each person. Therefore, there is nothing unattractive from slanted or big eyes. Everything is interesting, depending on how someone perceives it as attractive or not. "Indeed, there are patients who complain that they do not have double eyelids, which can be done by forming the upper eyelids, as well as patients with drooping eyelids and eye bags, which can be done operatively to correct them by operating the upper and lower eyelids," he continued.
Eyelid surgery, also known as blepharoplasty, is a procedure performed to remove skin or reduce fat on the eyelids. The purpose of this action is not only to improve appearance, but also to improve visual fields. Eyelid surgery can make a person look younger. In addition, this procedure can also improve sagging skin under the eyes or remove eye bags.
Operation Procedure
The blepharoplasty procedure can be done under local anesthesia in about 60 minutes. To make the eyes look bigger, the surgeon will make an incision along the lash line. Through the incision, some of the skin, muscle and fat in the eyelids will be cut and removed. That way, the eyes will automatically look bigger and there will be folds. Meanwhile, for those who want to get rid of sagging skin on the lower eyelid or eye bags, the surgeon will make an invisible incision inside the lower eyelid. To repair sagging skin tissue on the upper and lower eyelids at the same time, the surgeon will work on the upper side first.
There are several things that patients should know before and after carrying out this procedure. Patients are advised not to smoke and consume alcohol, vitamin E, herbs and herbs that can thin the blood for 2 weeks before and after surgery. In addition, blood thinning drugs such as aspirin, clopidogrel and so on need to be stopped for 5 days before surgery. "Patients need control for at least 1 week postoperatively to remove stitches and postoperative evaluation," he said. Then, if the results of the blepharoplasty operation itself can be seen from the post-surgery with the folding of the eyelids, or the loss of eye bags. However, the final results, like other plastic surgery operations, can be seen in the 3rd month after surgery.
- LIPS
Having full and thick lips is considered by most people to be beautiful and sexy. The more beautiful the shape of the lips, the more beautiful a person's smile. The characteristic of beautiful lips is a thick lower lip with clear lip lines. The length of the lips should match the distance between the left and right eyes and the corners of the lips should be light when lifted. "Currently, full lips with firm lip boundaries are still a trend," he admits.
Lip Shape Standard
For those who have thin lips, adding volume to the lips can make them fuller and more sensual. Or for those who have lips that are too thick, reducing the volume of the lips can be an alternative that can be done to create ideal lips. "But the standard of sexy and attractive lips is of course very subjective and follows the trend. But if we look for standard statistical references for lip size for each race, of course there will be research," he explained.
According to the results of research conducted by a group of scientists analyzing fashion spread photos published in Vogue magazine over a period of 50 years, the ideal and most desirable lips for women are those that are thicker at the bottom than at the top. Research conducted by the University of California found that the most common lip shape that appears in magazines is the ratio of 0.68. That is, the women who modeled for Vogue, on average, had a proportion of lips that were 47 percent thicker at the bottom.
Volume Reduction Or Increase
There are two methods to get beautiful lips, namely increasing the volume of the lips, or reducing the volume of the lips. For thin and asymmetrical lips, non-operative measures such as fillers and operative augmentation with fat grafts and implant implants can be performed. “Lip fillers can be done directly during the consultation. The trick, the filler is filled in the lip area that you want to augment. Operations can be performed with local anesthesia," he explained.
The procedures carried out include injecting fat taken from the body into the lips, usually the fat is taken as part of a liposuction procedure that is specifically for lip augmentation. Fat taken usually from the stomach or from the buttocks. Another way is to use the dermis or part of the skin that is used as a graft. Meanwhile, for those who have too thick lips, lip reduction or lip volume reduction can be done. In this method, excess lip tissue is removed with an incision in the lower or upper lip area.
In general, this procedure can take approximately 60 minutes and is performed under local anesthesia. The swelling and scars that appear will disappear after 7 days after surgery. Abstinences that must be followed by patients before and after surgery are not smoking and consuming alcohol, vitamin E, herbs and herbs that can thin the blood for 2 weeks. What is equally important is to avoid blood-thinning drugs such as aspirin, clopidogrel, etc., which need to be stopped for 5 days before surgery. As with any surgical procedure on the eye, the patient is required to be in control for at least 1 week after surgery to remove stitches and postoperative evaluation. Maximum results in lip surgery are seen in the 3rd postoperative month.
- CHIN
The chin is the main component at the bottom of the face so it plays an important role in the appearance and harmony of the face as a whole. A balanced and symmetrical chin shape is aesthetically pleasing. "The chin is also the main factor forming the character of the face. For example, a short chin will give a soft and feminine impression, while a protruding chin will give a strong and firm impression," added dr. Puri Ambar Lestari, Sp. BP-RE, a plastic surgeon from EMC Cikarang Hospital.
Chin Form Standard
Although there is no definite standard for the ideal chin shape, of course everyone, especially women, wants to have a chin shape that is in harmony with the shape of their face. “Society has different preferences regarding the shape of the chin, and these preferences may change by time, nation and race. The trend for a sharp chin will indeed give a thinner face, but it still has to be adjusted to the proportions of the face," added Dr. Puri with a smile.
Dr. admits Castle, chin is said to be beautiful if it is appropriate and in accordance with the proportions of the upper, middle and lower face. The ideal chin position is when it is parallel to the tip of the nose. If the patient has a chin shape that he thinks is less beautiful or asymmetrical, then the surgeon needs to do an evaluation first, to determine whether the chin profile is less or more impressive (too prominent). Chin Augmentation, Mentoplasty, or chin reshaping surgery is a surgical procedure to reshape the chin, either by adding implants or reducing/eroding bone.
according to dr. Castle, for a chin that is less prominent or asymmetrical, actions that can be done, starting from the simple one, namely with fillers, or invasive procedures by placing implants or surgery to cut the chin and move it forward and fix it with a plate . Meanwhile, chin implants are an option for patients who want a longer or more advanced chin profile, tailored to the patient's needs, in a way that is faster, relatively simple and provides permanent results. "There is no specific standard in the selection of chin implants, what needs to be considered is whether the patient has disturbances in the bite position of the upper and lower jaw (malocclusion)," dr. Castle gave an explanation. The most commonly used materials for chin implants are solid silicone, high-density polyethylene (HDPE), Gore-Tex and hydroxyapatite.
Procedures and Side Effects
Prior to surgery, the patient will receive a detailed examination of the position of the jaw, facial bones, and other organs and structures of the face. The operation is performed by cutting horizontally and/or vertically from the part needed to achieve a symmetrical and balanced jaw shape. For those who need implants, a cut can be made either inside the mouth or under the chin. Then the implant is placed. Installed implants can be locked with a screw , but some are not. Operation duration between 1-2 hours.
Patients are required to stop taking vitamins C and E 1-2 weeks before surgery to reduce the risk of bleeding. Before and after surgery, patients are asked to stop smoking and consuming alcoholic beverages so that the healing process of the operation goes well. Dr. Puri added, post-surgery patients are advised to eat soft foods, maintain oral hygiene and not work hard for 2 weeks. The results of surgery will usually be immediately visible, but will be clearer over 1 month postoperatively, after the swelling subsides. Patients will be asked to control weekly in the first month, then 3 months, 6 months and 1 year. "Usually there are side effects and risks of the procedure such as sensory nerve disturbances which are usually temporary, hematoma, deep indentation between the lips and chin, irregular edges, asymmetry and ptosis of the chin," explained dr. Castle.
- JAW
Not only the nose, eyes, lips, and chin, the jaw is also one of the parts of the face that is the main attraction and forms a part of one's appearance. "As part of the appearance of the lower face, the lower jaw also plays a role in giving a person's facial character," said dr. Castle. The concept of a beautiful jaw shape varies among different cultural groups. There is no specific benchmark for everyone because Asians may have less slender jaws but still look attractive.
According to him, the shape of the jaw, especially in Asian women, is slim and the oval face is much in demand by some people because it gives an attractive impression. "If a woman has a square jaw, it will give the impression of a hard, masculine and unattractive face," he said.
Jaw Contouring
If anyone feels that they have a jaw shape that is less beautiful or asymmetrical or even too square, dr. Puri suggested consulting a surgeon first for an examination. "It is necessary to recognize the problems regarding the jaw which are the complaints of patients. It is also necessary to evaluate the soft tissue above the jaw, such as the masseter muscle and also buccal fat ," he said.
Jaw Contouring or jaw shaping is useful for improving the structure of the jaw by repositioning the upper jaw (maxilla) and lower jaw (mandible) so that it will produce balanced facial proportions. To give a softer face effect to a square jaw, you can cut the angle of the jaw. "In patients with a full lower face, in the thick masseter muscle , part of the muscle can be cut and also excised buccal fat ," he explained again.
Operation Procedure
The operation is performed by cutting horizontally and/or vertically from the part needed to achieve a symmetrical and balanced jaw shape. according to dr. Puri, a wound can be made under the corner of the jaw or from inside the mouth, then the bone area in the corner of the jaw will be cut according to the previous design," said Dr. Puri, adding that this procedure takes between 3-5 hours. Side effects and risks that may arise, namely complications that may occur are bleeding, sensory loss in the chin, both temporary and permanent, asymmetry, skin sagging or overcorrection.
As with other plastic surgery procedures, before and after surgery, patients are asked to stop smoking and consuming alcoholic beverages and to stop taking vitamins C and E should be stopped 1-2 weeks before surgery. Postoperatively, patients are advised to eat soft or liquid foods for 2 weeks postoperatively, maintain oral hygiene, and not exercise heavily for 3 months. "The results will be seen after the swelling subsides, about 1 month postoperatively," said dr. Castle.
Article written by dr. Puri Ambar Lestari, Sp. BP-RE (Plastic Surgery Specialist - Reconstruction and Aesthetics at EMC Cikarang Hospital).