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Tailor facial contouring to unique needs of Asians

Toronto, Canada — Facial contouring requires unique considerations in the Asian patient, according to Joseph Wong, M.D., a facial plastic surgeon based in Toronto, Canada, and president of the Canadian Academy of Facial Plastic and Reconstructive Surgery.

"One of the issues with reconstructive surgery in the Asian patient is scarring," says Dr. Wong. "Asian patients don't have sufficient skin pigment to cover scarring. Surgeons have to know how to prevent it from happening, and how to deal with it if it does happen."

Plastic surgeries also involve other more common complications such as risk of bleeding, nerve damage, bruising, swelling and infection, notes Dr. Wong, who primarily treats Asian patients. The healing process also can be quickened or slowed by factors such as stress, diet, fatigue and mental attitude.

Screen patients carefully He adds that plastic surgeons should carefully screen patients to ensure that they don't have unrealistic expectations about the procedure. Taking pre-operative photographs and using computer imaging to provide a snapshot of the potential post-surgical results can help a patient to understand the true possibilities. Patients should also be counseled about how to apply make-up, should they use it, post-operatively.

Moreover, if the patient's motivation is negative and indicates a possible psychological disorder, as in the case of an anorexic patient who requests a tummy tuck, the surgeon should advise against the procedure and urge counseling.

"It should be a warning signal," Dr. Wong says. "It would be fair to conclude the patient has self-esteem and self-image issues."

Facial contouring is done through augmenting deficient areas or reducing overly prominent areas, explains Dr. Wong. Augmentation consists of filling in areas with the patient's own tissue or with biocompatible implants.

Reduction of the mandible in a round or angular face to create a more oval or heart-shaped face is a common request among Asian patients. By contrast, Caucasian patients may request augmentation of the angle of the mandible, achieved through the use of implants, to change an oval or round face into a more angular one.

The incisions involved in facial contouring are fairly inconspicuous and are done either from inside the mouth or within the hairline or the skin creases.

Eyelid surgery common Upper eyelid surgery is very common among Asians, but some misperceptions persist about the procedure, Dr. Wong says.

"It is a myth that Asians who have the upper eyelid procedure want to look Caucasian," he says. "They want it to look natural. When I see 25-year-old patients who have the procedure done to look Western, they look 20 years their senior as a result. It is not suitable for them."

Westernization of eyelids creates a peculiar and aging appearance of the upper eyes in an Asian person, Dr. Wong says.

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