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[ARTICLE] Revision Facial Contouring Surgery Requires Precise Diagnosis to Restore Facial Balance Through Structural Reconstruction

Revision facial contouring surgery requires thorough evaluation of bone structure, resection extent, causes of facial asymmetry, and nerve location As more patients experience unsatisfactory outcomes following facial contouring surgery—including insufficient improvement, facial asymmetry, sagging cheeks, or bone defects caused by excessive bone reduction—the number of people seeking revision facial contouring surgery continues to rise. Because revision surgery involves correcting facial bones and soft tissues that have already undergone surgery, it is significantly more complex than the initial procedure and requires meticulous surgical planning and advanced technical expertise. In recent years, the approach to revision facial contouring has shifted away from simply removing additional bone to make the face appear smaller. Instead, the focus has moved toward analyzing the structural changes caused by the previous surgery and restoring facial balance. Modern revision procedures empha...

[ARTICLE] When Is the Right Time to Remove Fixation Plates After Facial Contouring or Orthognathic Surgery?


An increasing number of patients who underwent facial contouring or orthognathic (double jaw) surgery years—or even more than a decade—ago are now visiting clinics to have the fixation hardware remaining in their faces removed.

During facial bone surgery, titanium plates and screws are routinely used to stabilize the bones while they heal. In many cases, these fixation devices are left in place permanently if they do not cause any symptoms. However, as time passes, more patients become aware of the hardware during dental treatment, routine health check-ups, or X-ray examinations performed for overseas travel. Others simply feel uncomfortable knowing that foreign materials remain inside their bodies, leading them to consider removal.

According to specialists, fixation plates and screws are made from biocompatible medical-grade materials and are generally considered safe for long-term use. Nevertheless, after many years, some patients may experience discomfort or a sensation of a foreign body, while others choose removal as a preventive measure against potential future issues. Therefore, the decision to remove the hardware should be based not only on the presence of symptoms, but also on factors such as the time elapsed since surgery, the degree of bone healing, and the patient's overall health.

In particular, removing fixation hardware five to ten years or more after surgery can be significantly more challenging than routine plate removal. Over time, the bone naturally remodels, and the plates and screws may become deeply embedded or firmly fused with the surrounding bone. As a result, surgeons must carefully remove the hardware while protecting nearby nerves, blood vessels, and soft tissues, making thorough preoperative evaluation and advanced surgical expertise essential.

Dr. Kwon Soon Beom, Chief Surgeon of ARC Plastic Surgery, explained,"Removing long-standing fixation hardware is not simply a matter of unscrewing the plates. It is a technically demanding procedure that requires a precise understanding of how the bone and surrounding soft tissues have changed over time. Before surgery, detailed imaging studies such as 3D CT scans are essential to accurately evaluate the location of the hardware and the degree of bone integration. The goal is to remove the hardware while minimizing damage to the surrounding bone."

He further emphasized, "Every patient differs in terms of when the original surgery was performed, the condition of the bone, and the extent of bone integration. Rather than applying a one-size-fits-all approach, each patient requires an individualized diagnosis and surgical plan. It is also important to choose a medical institution that minimizes unnecessary incisions and excessive bone removal while providing comprehensive postoperative care, including swelling management, scar care, and regular follow-up."
Experts also advise that patients considering the removal of long-standing fixation hardware should not simply ask whether removal is possible. Instead, they should undergo detailed imaging studies and consultation with a qualified specialist to accurately assess their current condition, carefully evaluate the necessity and optimal timing of removal, and establish an appropriate treatment plan.

Source: Medisobizanews (www.medisobizanews.com

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