Facial skeletal surgery in the aging face

Modifications of the facial skeleton with alloplastic augmentation, on-lay grafts, or repositioning of bony fragments by osteotomy are extremely useful adjuncts in rejuvenation of the aging face. Minor disharmonies with normal dental occlusion can usually be best achieved with on-lay grafts or alloplastic augmentation. More extensive deformities require osteotomy and repositioning of bony parts. Reductions in height and anterior projection must be performed with caution because soft tissues do not shrink as readily in patients over 30 years of age.