Aesthetic contouring of the facial support system.

The skeletal foundation and its attachments provide a basis for changing the basic structure of the face. Detailed preoperative evaluation and a clear understanding between the patient and surgeon of the aesthetic goals are essential prior to proceeding with surgery. Besides a knowledge of the normal aesthetic and arthropologic measurements, the surgeon must have an understanding of the range of methods available prior to proceeding with surgery. For minor alterations, contour reduction or augmentation should be considered. In the temporal fossa, augmentation with synthetic material is preferred. In the supraorbital ridge and chin autogenous tissue is generally the material of choice. An understanding of when and how to use these materials is the essence of achieving satisfactory results.