Facial aesthetic surgery in Thessaloniki and Athens, Greece: proportions, nose, lips and contour

I assess facial proportions on two levels: from the front, by dividing the face into three thirds, and from the side, by looking at how the nose, lips and chin relate to each other. There is no single template. Measurements show where the imbalance lies, but the decision is based on your own face and what bothers you.

The three thirds of the face

The position and shape of the eyebrows matter a great deal, in women and men alike, and are closely linked to a youthful, rested expression. The shape and size of the forehead determine how masculine or feminine a face looks and play a large part in its overall proportions. Ideally, the forehead takes up one third of the face, equal to the middle and lower thirds.

The profile: nose, lips and chin

In profile, I always judge the nose, lips and chin together. A small or set-back chin makes the nose look larger than it is, and a large chin can make a normal nose look small. That is why, when someone comes to me about their nose, I always look at the chin from the side as well.

The nose should suit the chin and the eyes. I usually suggest a straight bridge with a slightly lifted tip, not an upturned “ski-slope” nose. On the upper lip I measure the philtrum, the distance from the base of the nose to the edge of the lip: around 15 mm or more in younger patients and 16 mm or more in older patients, with a lip that covers the upper teeth, points to a lip lift.

The chin is also judged against the bite. If the problem is the bite itself, corrective jaw (orthognathic) surgery may be needed, with a first assessment by an orthodontist or a maxillofacial surgeon. At the consultation I photograph your face from the front and the side; a simulation shows the change but does not guarantee the result.

Each feature has its own operation: rhinoplasty for the nose, a lip lift for the upper lip, implants for the chin and cheekbones, buccal fat removal for the cheeks and otoplasty for the ears. A large chin is made smaller by reshaping the bone. The table matches each operation to the concern it treats.

Rhinoplasty. It corrects the shape of the nose and breathing in the same operation, including the septum and turbinates. I perform most with an open structural technique; they take 2 to 2.5 hours and need no hospital stay. Full details are on the rhinoplasty page.

Lip lift. I remove a thin strip of skin under the nose through a bullhorn incision, so that the whole lip lifts evenly. It is done under local anaesthesia in about half an hour. See the lip lift page.

Chin and cheekbones. For projection, I place solid silicone implants through the mouth, leaving no scar on the skin. I make a large chin smaller by reshaping the bone, also through an incision inside the mouth. See the facial contouring page.

Buccal fat removal. I conservatively remove only part of the buccal fat pad, through the mouth, and select patients strictly, so that the face does not look hollow over the years. See the buccal fat removal page.

Otoplasty (ear pinning). Through an incision behind the ear I correct the concha, the antihelix or both, in children from the age of 4 and in adults. See the otoplasty page.

I combine operations that change the proportions of the same profile or the same area, such as rhinoplasty with a chin implant, or a lip lift with buccal fat removal. The change is then planned as a whole, with one anaesthetic and one recovery. I do not combine them when it raises the risk or when one decision should wait.

Rhinoplasty with a chin implant. This is the most common combination, because the nose and chin shape the profile together. The implant adds about 20 minutes to the operation and is placed through an incision inside the mouth. Planned together, the change to the profile is better balanced and you recover only once.

Lip lift with buccal fat removal. Both are done under local anaesthesia or sedation and change the lower half of the face: the lip lifts and the line below the cheekbones becomes cleaner. They are done together in one operation, usually in about 1 to 1.5 hours in total.

Buccal fat removal with a chin or cheek implant. As the cheeks become slimmer, a stronger chin or more defined cheekbones balance the facial contour. All incisions are inside the mouth.

Otoplasty in adults. It can be combined with other minor facial procedures, which we discuss at the consultation.

When I do not combine procedures:

• When the total operating time or the type of anaesthesia raises the risk more than the combination helps.
• When the chin comes with a significant bite problem; an orthodontist or maxillofacial surgeon assesses it first.
• When the face is already slim or your weight is not stable; buccal fat removal is then not part of the plan.
• When there is active inflammation of the teeth, gums or mouth; operations through the mouth are postponed.

If what bothers you is a feature you have always had, such as your nose, chin or ears, you need aesthetic surgery. If it is something that has changed with age, such as laxity along the jaw, in the neck or around the brows, the route is facial rejuvenation, which the facelift guide covers.

The distinction matters because the two routes correct different things. A chin implant gives projection, but it does not lift sagging skin along the jawline. Buccal fat removal slims a full, young face, but in an older face with laxity the volume needs to be kept, and that is when we talk about a facelift.

Some operations belong to both routes. A lip lift corrects a naturally long lip in young people, and also a lip that has lengthened with age; in that case it is often done together with a facelift, because a facelift does not shorten the upper lip. In otoplasty for older patients, large earlobes are usually corrected during a facelift. At the consultation I explain which route suits your face.

Injectable materials add volume, but they do not move tissue or change the bone structure. When volume no longer gives the result you want, surgery changes the shape directly: it makes the nose smaller, shortens the lip or gives the chin permanent projection. I do not perform injectable treatments and I do not treat complications of injectable materials.

Three examples show the difference. Injectable material in the lip adds volume, but it does not shorten the distance from the nose to the lip; a lip lift does, with a result that lasts many years. Injectable material in the nose can hide a small hump, but it does not make the nose smaller or improve breathing, which rhinoplasty does. In the chin and cheekbones, a solid silicone implant gives permanent projection without repeated injections.

If you want volume from your own tissue, I use fat transfer, mainly alongside other operations. If you have injectable materials in the area to be operated on, tell me at the consultation, because they affect the planning. As a rule, injectable material that can be dissolved should be dissolved at least 2 weeks before surgery; permanent materials are assessed individually.

• Open or closed rhinoplasty
• Rhinoplasty: common misconceptions
• Rhinoplasty techniques
• Rhinoplasty in men
• Fat transfer to the face
• When injectables are no longer the answer