Facial Contouring




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    Face contouring procedures are designed to create highlights and shadows in the face and jawline. Makeup is one of the most known “at-home” techniques used to create beauty and better facial contouring. But if you desire safe, simple and permanent facial contouring changes to the cheeks, nose, jawline, you may be an excellent candidate for facial contouring surgery to remove excess fat, to raise facial areas that are sagging, or to enhance your facial shape.

    Facial contouring surgery is done on an outpatient basis and has quick healing times and immediate results.


    Our bichectomy surgery (buccal fat pad removal) is a safe and permanent procedure which will contour the face and make the face look slimmer and more angled.
    Dr. Gabriele Miotto, Atlanta Plastic Surgeon.


    What is face contouring?

    Facial contouring is any surgical or nonsurgical procedure which changes the highlights and the shadows of the face to make it look more attractive, more symmetrical and even more rejuvenated.

    Do I need surgical face contouring?

    You are a good candidate for surgical or non-surgical facial contouring if you want to make changes in the shape of your face to rejuvenate, create highlights and reduce the signs of aging. Other reasons:

    1. You have excess fat in the lower cheek area (large buccal fat pads) under the jawline (“double chin”) and you would like to improve it to create a slimmer look to your face.
    2. You lack natural contouring and would like to add permanent shadows and highlights to your face and jawline.
    3. You have a round shaped face, but want a narrower, slimmer and more angled shape.
    4. You have hollowing under the cheeks.
    5. You would like to mildly lift the brows, or highlight the lips or temples.
    6. You want to add fullness back to the cheeks.


    We utilize several face contouring options individually, or they can be performed together, under local anesthesia or under general anesthesia.


    How are facial contouring procedures performed?

    Facial contouring can be achieved with a combination of several procedures, most commonly buccal fat pad removal (“bichectomy”), facial fat grafting, localized liposuction and suspension sutures. We utilize these several options individually, or they can be performed together, under local anesthesia or under general anesthesia, depending on each case. We also have non-surgical facial contouring options such as facial injections with fillers.

    What are facial contouring surgery options and techniques?

    Surgical procedures for facial rejuvenation are small and combined surgical procedures done under a local anesthesia, such as buccal fat pad removal and liposuction of the “double-chin”. These are non-invasive treatments ideal for patients wanting a small and gradual improvement.

    Sometimes when we need to restore facial volume, we can do fat grafting to cheeks, temples, nose, lips, jawline and lower lids to replace the fat tissue lost with aging and recreate facial contours and highlights. Fat grafting is also a wonderful treatment for skin aging.

    1. Neck liposuction – removes the double chin. It is done with a local anesthesia by making a small incision under the chin and removing the fat permanently out of the neck area using a very fine liposuction cannula.
    2. Buccal fat removal or bichectomy – we remove the excess lower cheek fat (enlarged buccal fat pad) through the inside of the mouth with local anesthesia. This will contour the face and make the face look slimmer and more angled. This procedure can also be performed as part of a facelift when the patient has a bottom heavy face. We would also be performing tightening and repositioning of the tissues as part of the facelift to treat jowls and deep facial folds.
    3. Fat grafting – restores facial volume and highlights. Can be used to any facial area that has had loss of fat. Fat is removed with a fine cannula from the stomach, thighs, waistline and transferred with delicate cannulas to the face. This can be done under local anesthesia or under general anesthesia.
    4. Suspension sutures – less invasive facial lifting procedure, allows for a mild brow lift, some contouring of the cheeks, improvement of the jawline and jowls. This can be done under local anesthesia or under general anesthesia.
    5. For the neck lift we have a new procedure called Elevate®. This facial contouring method is a little more durable, but still performed under local anesthesia. We perform liposuction of the neck to remove the fat and we place surgical threads from the chin over to the mastoid area (behind the ear), lifting and contouring the neck to create highlights and to emphasize the jawline.

    Is there non-surgical face contouring?

    Yes, we have several non-surgical face contouring techniques. These are a combination of individualized facial treatments with dermal fillers, botulinum toxin (Botox/Dysport), collagen biostimulation, neurotoxins and suspension sutures.

    Another non-surgical option to remove fat from the neck is done with Kybella®, which is a product we inject into the superficial fat in the neck to eliminate the unwanted fat. Several sessions are needed to achieve complete removal of the fat, and the procedure is done in the office with minimal downtime.

    Will others see my facial contouring incisions?

    No, the facial contouring incisions should not be visible. When the closure is made correctly and with attention to detail, the incisions are hidden inside the mouth (buccal fat pad), in the hairline (Ellevate), and under the chin (liposuction). Scars will be virtually invisible six months after surgery.

    How much time will I need to recover after facial contouring surgery?

    Recovery time depends upon which technique we perform, and whether you have had a local or general anesthesia. The procedure itself can be done in one day. The average downtime is about 1-2 weeks after surgery. Some patients have more swelling or bruising than others, so it may take about 3 weeks for the most visible signs of surgery to be gone.

    Is it better to have facial contouring or a complete facelift?

    Whether you decide to have individual face contouring surgery or a complete facelift is dependent on how much visible facial aging you have and what results you would like to achieve for your face shape. If we only want to remove excess cheek fat, for instance, a bichectomy can be done by itself to contour the face and make the face look slimmer and more angled.

    If you are not happy with your face and neck as a whole, facial contouring, combined with improvements to the neck, nose, eyelids and lips, may be the best choice for you. Changes can be done gradually or all together, it depends on your goals and timeline.

    A complete facelift includes:

    • Facelift to lift the cheeks, jowls, corners of the mouth, deep wrinkles in the face
    • Neck lift and platysmaplasty to neck bands
    • Fat grafting to the face to improve facial highlights and loss of volume

    After facial contouring surgery how can I have healthy skin?

    Facial contouring does not stop the aging process, but it is a “reset” in time. We offer a number of medical skin treatments and medically graded skin care products to help maintain the surgical results long term, including improving the texture of the skin, the pores and fine lines. A healthy lifestyle is also a part of the maintenance of any facial aesthetic procedure.

    How can I get started to learn more?

    We welcome you to come in and discuss what facial contouring procedures, surgical or non-surgical, will give you the most beautiful result to contour your face, highlight your facial features, and make you look rejuvenated and refreshed.
    We can talk about what you want to achieve, go over the specific areas you are looking to improve, and I will answer any questions you have.

    Plastic surgery through a woman’s eye

    Dr. Gabriele Miotto, Atlanta plastic surgeon known for her beautiful, natural results and high patient satisfaction.

    Surgery and Recovery Information

    After the facial contouring procedure

    Facial contouring procedures can be done under local or general anesthesia, depending on what type of combined procedures are performed. After the procedure, there will be some bruising and swelling. Swelling can be minimal or more intense depending on how many procedures need to be done to make the results the most beautiful and natural possible.

    Frequently combined procedures for facial contouring are fat grafting to the face, liposuction, suspension sutures, dermal fillers, buccal fat pad removal (bichectomy), skin treatments inlcuding resurfacing, lip lift. There are many options for us to use to achieve the best results.

    Return to normal daily activities between 1-2 weeks. Expect at least 8 weeks for committing to major social events as residual swelling can remain for some patients after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising.

    General preoperative recommendations for facial contouring procedures:

    What to avoid before:

    1. DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
    2. Discontinue Vitamin E 10 days before surgery.
    3. Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
    4. Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
    5. Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.

    What to take before surgery:

    1. Dr Miotto recommends some supplements before and after the procedures to speed up recovery during the office consultation.

    General postoperative recommendations after facial contouring procedures:

    1. If general anesthesia is used, you need a responsible adult to take you home, we will not allow you to drive or be home alone immediately after surgery.
    2. You will be unable to drive if you are taking narcotics.
    3. It is recommended to elevate the head with two to three pillows after all facial procedures.


    1. If your prodecure was done under general anesthesia, we require that you have a responsible adult stay with you for twenty-four hours after your surgery for general help, as you may find your balance and judgement impaired.
    2. Please refrain from intense physical activity that will increase your heart rate or blood pressure for 1 week after surgery.


    1. You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
    2. Do not scrub the surgical sites, however you can allow soapy water to run over them.
    3. For buccal fat pad removal, mouth rinse with chlorhexidine is recommended for 48hs, and soft food for 72h.

    Returning to Work:

    1. Recovery time will vary; isolated facial contouring procedures will have a fasted recovery. Combined surgical procedures will cause more swelling and bruising, and may need 1-2 weeks of recovery.


    1. Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
    2. Eat a few bites of food before taking pain medications as these can cause nausea.
    3. A diet low in sodium will help minimize swelling and water retention.
    4. Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.
    5. After a buccal fat pad removal procedures (bichectomy), eat a soft diet for 72h to avoid opening the wound inside the mouth.

    Final Results:

    1. Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
    2. It can take months for the very final results of your surgery be apparent. After 8-12 weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing (including the appearance of scarring) to continue to improve for up to six to twelve months.
    3. It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.

    GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, nose, breast and liposuction.
    Call 404-850-5851 for your consultation.



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