By: Dr. Benji Dhillon, MD
Despite being a cosmetic surgeon focused on injectable based treatments, I have come to appreciate the importance of a beautiful smile and the role it plays in facial esthetics. The lips are an important esthetic subunit in repose, but the smile in animation is equally, if not more, important.
Although cosmetic dentistry can play a vital role in the restoration of function, smile rejuvenation has a significant impact on facial beautification. However, solely enhancing the dentition means focussing on only one esthetic subunit, which is sub optimal. After all, the golden proportions of facial beauty refer to the whole face.
In the field of facial esthetics, I firmly believe consultation and assessment is 70 percent of a great esthetic outcome, with product or procedure choice and technique also playing a role. Consequently, it is vital to implement a specific facial esthetics consultation algorithm. There are numerous processes available, but I believe there are three key rules to abide by:
1. Assess the facial shape.
The ideal female face shape, for example, is a heart to oval shaped face. There should be a greater bi-zygomatic than bi-gonial distance, a soft ogee curve and the chin should be narrow and come to a gentle point inferiorly.
2. Assess the facial thirds.
Examine each third in detail taking into account details such as forehead volume loss; eyebrow position in the upper third; cheek volume; the presence of a tear trough or deep nasolabial lines in the middle third; and lack of jawline definition, chin retrusion/protrusion and lip volume in the lower third. For each third, note the anatomical structure involved, such as deep or superficial fat compartments. There will be important ethnic differences to be considered in each third.
3. Assess the negative emotions of the face, such as tiredness (peri orbital volume loss) or sagginess (midface and lower face volume redistribution).
Once there is an appreciation of these areas, a beautification plan can be made depending on patient priorities. However, it is the responsibility of the physician to ensure patients understand that simply volumizing the lips or cheeks may not elevate their esthetics. Facial proportions, or aiming for them, must be adhered to. If there is a masculinisation of the face in females, with a wide jaw, then either botulinum toxin to atrophy the masseter and narrow the jawline or dermal fillers to volumize over the zygomatic arches and widen the upper third is warranted.
To enable a patient who has undergone smile rejuvenation to understand how their facial esthetic outcomes can be elevated, education is required. I make it my responsibility to spend time educating every new patient in my practice about how their face ages over time and the anatomical changes that occur. This ensures they understand the basis of treatments that can be used to modify these changes.
A new kind of practice
I’m committed to whole face beautification and because of that, I’m opening what I believe to be a first: A practice with two dedicated teams for cosmetic dentistry and cosmetic surgery under one roof, one brand and with one patient journey. My partners and I have developed consultation protocols and pathways that allow us to conduct combined consultations to assess the whole face. We’ll be able to offer unique treatment plans that ensure optimal long-term patient outcomes and satisfaction.
