Three-dimensional facial contouring: utilizing upper-midface suspension technology and alloplastic augmentation.

Facial aesthetic surgery procedures have evolved to the highest level possible, the three-dimensional restructuring of facial form. Repositioning of the deep soft tissue planes from the neck to the zygoma as well as subperiosteal, upper, and midface elevation have become commonplace. Alloplastic implant contouring is not only a useful adjunct, but it should be a fundamental tool used with the variety of new facial aesthetic techniques. It is now possible for the aesthetic surgeon to variously restore, rejuvenate, or enhance facial forms of either hereditary or aging origins. Infinite variations in facial contour are now possible. By using alloplastic techniques based on concepts of zonal anatomy and aesthetic deficiency typing, the bony and soft tissue contours of the face can be created or modified with a minimum of complications. The use of alloplastic implants on the "fourth skeletal plane" represents an optimum, significant, three-dimensional manipulation of both the soft tissues of the face and the skeletal anatomic elements of mass and volume.