Facial Contouring in Thessaloniki and Athens, Greece

Facial contouring is a group of operations that change the bony framework or the volume of the face at the chin, cheekbones and cheeks. I add projection with solid silicone implants, or reduce volume by burring the bone or removing fat. Incisions are made inside the mouth, so there is no scar on the skin.

Cheek and chin implants are usually ready-made, in solid silicone. In special cases I use other materials or custom-made implants.

For the chin, volume or projection can be reduced by burring the bone or by an osteotomy, again through incisions inside the mouth. In full cheeks, part of the buccal fat pad is removed.

These operations are often combined with each other, or with rhinoplasty or a facelift, because the chin and cheekbones set the proportions of the face. Where needed, I add fat transfer or nanofat.

It suits healthy adults whose facial growth is complete and who want more balanced proportions of the chin, cheekbones or cheeks. If the real problem is how the teeth meet (the bite), the answer may be orthognathic (jaw) surgery instead. Whether it suits you is decided at the examination.

At the consultation I examine your chin, cheekbones and cheeks from the front and side, together with their relationship to your nose and teeth, and take photographs. Preparation is simple: blood tests, healthy teeth and gums, no smoking for 4 weeks before and after, and a word with me about any blood thinners.

What happens at the consultation?

I examine the chin, cheekbones and cheeks from the front and in profile, together with their relationship to the nose and teeth, and photograph the face. I explain the choice between an implant and an osteotomy, and between cheek implants and a midface lift. You receive a written plan and cost.

What tests and instructions apply before surgery?

You will need blood tests and, where needed, a heart check; for chin reduction under general anaesthesia, an assessment by the anaesthetist as well. The incisions are inside the mouth, so your teeth and gums must be free of inflammation. Stop smoking 4 weeks before and after surgery. If you take blood thinners, tell me; only the doctor who prescribed them decides whether to stop them.

Chin and cheek implants are placed under local anaesthesia (anesthesia), fat transfer is done under local anaesthesia or sedation, and chin reduction under general anaesthesia. Operating time ranges from 20 minutes to 1 hour. Incisions are inside the mouth and the stitches dissolve; fat transfer also needs a few tiny incisions on the skin.

Implants are usually ready-made, in solid silicone; in special cases I use another material or a custom shape. The table summarises the four operations.

Operation	What it does	Incision	Anaesthesia	Operating time
Chin implant	Adds projection to a small or receding chin	Inside the mouth	Local	About 20 minutes
Cheek implants	Defines the cheekbones	Inside the mouth	Local	45 minutes – 1 hour
Chin reduction	Reduces volume and projection by burring or osteotomy	Inside the mouth	General	About 1 hour
Fat transfer	Adds volume to the face in a natural way	With a cannula	Local or sedation	45 minutes – 1 hour

Chin implant (chin augmentation)

For a small or receding chin, I place a solid silicone implant through a small incision inside the mouth, in a pocket on the chin bone. The result is permanent and stable [1]. The operation takes about 20 minutes under local anaesthesia. I usually prefer an implant to an osteotomy (a genioplasty that moves the bone itself), because most patients prefer to avoid cutting the bone when it can be avoided [2]. A chin implant is often planned together with rhinoplasty, because the nose and chin shape the profile together; see the rhinoplasty page.

Cheek implants (cheek augmentation)

When the bony framework of the midface is weak, I place solid silicone implants, ready-made or custom-made, through an incision inside the mouth above the upper teeth [1]. The operation takes 45 minutes to 1 hour under local anaesthesia. Alternatively, the cheekbones can be enhanced with your own tissues through a midface lift; see the midface lift page.

Chin reduction

When the chin is large or very prominent, I reduce the volume and projection of the bone by burring or, when a bigger change is needed, by an osteotomy [2]. The incision is inside the mouth; the operation takes about 1 hour under general anaesthesia. The same technique is used in facial feminisation surgery; see the facial feminisation page.

Fat transfer to the face (fat grafting)

Fat transfer adds volume to areas of the face that have hollowed, or fills a deep, marked wrinkle so that it shows much less. The fat is taken by liposuction from another part of the body and injected through incisions a few millimetres long. The drawback is that an unpredictable part of the fat is absorbed by the body, so we cannot predict exactly how much correction will remain after 9 months [6]. For this reason I use it mainly as an addition to other operations, and it may need repeating.

Did you know? In many facial operations I add nanofat: fat from your own body, processed into a very fine graft, which improves the quality and texture of the skin [5]. I use it as an addition to the operation and rarely on its own, because the share of fat that survives is unpredictable.

Incisions and stitches

All incisions are inside the mouth, so no scar is left on the skin of the face. The stitches dissolve and do not need removing. In fat transfer, the harvesting and injection incisions are made with a cannula and are hard to see from the first day.

Combinations

A chin implant is often combined with rhinoplasty, and cheek implants or buccal fat removal with a facelift or eyelid surgery (blepharoplasty). Fat transfer and nanofat complement many facial operations. For thin lips there is a surgical option; see the lip lift page.

Hospital stay

You do not need to stay in hospital for implants or buccal fat removal; you go home the same day. After chin reduction under general anaesthesia, most patients also go home the same day. After sedation or general anaesthesia you must not drive that day and you need someone to accompany you.

Most people return to office work 10 to 15 days after facial contouring, once the swelling has settled, and to manual work after 3 to 4 weeks. The incisions are inside the mouth and the stitches dissolve. For the first few days you eat liquids and soft food and take particular care with mouth hygiene.

When	How you feel	What you can do
Days 1–3	Swelling and tightness; mild pain controlled with ordinary painkillers	Liquids and soft food; mouthwash after meals; cold compresses; sleep with your head raised
Days 4–10	Swelling settles gradually; there may be bruising	Soft food, no hard chewing; gentle walking
Days 10–15	Most of the swelling has gone	Back to office work
Weeks 3–4	Sensation almost normal	Manual work and a gradual return to exercise, once cleared at your check-up
About 1 month	The result in the cheeks (buccal fat) is visible; final within about 3 months	Normal activity
About 3 months	The last swelling around the implants settles	Final assessment of the implants
About 9 months	The correction from fat transfer can be judged	We decide whether a second session is needed

Plan to stay in Greece for 5 to 10 days after facial contouring. Implants and buccal fat removal need no hospital stay, so you leave the hospital the same day; after chin reduction under general anaesthesia, most patients also go home the same day.

After sedation or general anaesthesia you cannot drive that day, so someone should collect you from the hospital. The stitches inside the mouth dissolve on their own, so there is no appointment to remove them. The swelling settles over 10 to 15 days, which is also when most people go back to office work.

You can fly home from day 5, after your final check the day before the flight. Your check-ups after you leave Greece are by video call at 10 days, 1 month, 6 months and 1 year, and clearance to return to exercise at 3 to 4 weeks is given at a check-up.

Before you travel, arrange things at home for the first days: liquids and soft food, mouthwash for use after meals, cold compresses, and pillows to sleep with your head raised. If you take blood thinners, speak to the doctor who prescribes them well before your trip, and stop smoking 4 weeks before and after surgery.

Chin and cheek implants and chin reduction give a stable, lasting result. The effect of buccal fat removal is visible at about 1 month and final within about 3 months. With fat transfer, part of the fat is absorbed unpredictably, so the result is judged at 9 months. Your face will keep ageing naturally around any implant.

Facial silicone implants have no set replacement date; they are removed or changed only if a problem arises or if you want a different size. The face, however, keeps ageing, and over the years you may need a facelift or another operation for loose skin. Fat transfer is not permanent in the same way, because the fat that survives follows changes in your weight.

Complications are few, but they exist: implant shift or infection, numbness, asymmetry and, with buccal fat removal, injury to a nerve. Swelling and bruising are common and temporary. I explain your own risk at the consultation; the table shows how often each complication occurs and how it is prevented and treated.

Complication	How common	Prevention and treatment
Swelling and bruising	Common, temporary	Cold compresses and head raised; settle in 10 to 15 days
Numbness of the lower lip or chin	Rare, usually temporary	Careful handling of the nerve; sensation returns within weeks to months
Numbness of the cheek or upper lip (cheek implants)	Rare, usually temporary	Careful placement of the implant; sensation returns within weeks to months
Implant shift	Very rare	A pocket of the right size; corrected by repositioning
Implant infection	Very rare	Antibiotics and good mouth hygiene; with persistent infection the implant is removed
Asymmetry	Very rare	Careful planning; corrected with a minor procedure
Injury to a branch of the facial nerve (buccal fat removal)	Very rare	A careful anatomical approach
Too little or uneven correction (fat transfer)	Not rare, as absorption cannot be predicted	A second session, after the result is judged at 9 months

Smoking. Stop for at least 4 weeks before and 4 weeks after surgery. Smoking raises the risk of infection, slows the healing of the incisions inside the mouth and lowers the success of fat transfer.

Blood thinners. Tell me if you take anticoagulants or antiplatelet medicines. Stopping them is always agreed with the doctor who prescribes them.

The cost of facial contouring differs from person to person, depending on the operation or combination of operations, the type of implant and the anaesthesia. Prices are not published: you receive a written quote after the consultation, once I have examined you and we have agreed together on the plan that suits you.

• Which operation is done, and in how many areas.
• The type of implant: ready-made or custom-made.
• The anaesthesia: local, sedation or general.
• Combination with another operation, such as rhinoplasty or a facelift.
• Adding fat transfer or nanofat.

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