Maxillofacial & facial skeletal surgery
Facial Skeletal Contouring & V-Line Surgery in Los Angeles
Facial skeletal contouring reshapes the bones that set the width and outline of your face. Dr. Husam Elias, board certified in oral and maxillofacial surgery and cosmetic surgery, uses 3D planning to slim, soften, or strengthen your facial frame while protecting the nerves and preserving natural harmony.
What Is Facial Skeletal Contouring?
Facial skeletal contouring is surgery that reshapes the facial bones to change the overall shape and width of the face. It may narrow a wide lower face, soften a square jaw, reduce prominent cheekbones, or, when the frame is underdeveloped, add structure where it is missing. The goal is a face whose outline feels balanced from the front, in profile, and at every angle in between.
Where our chin and jaw surgery page focuses on the position and projection of the chin and the line of the jaw, facial skeletal contouring looks at the face as a whole: how wide it appears, how the cheekbones relate to the jaw, and whether the face tapers or reads as broad and heavy. Many patients seek it to create a slimmer, softer, or more oval face, a goal often described as a V-line.
Bone or Soft Tissue? Finding the True Cause of Width
A full or wide face is not always a bone problem. Enlarged masseter muscles, the chewing muscles at the back of the jaw, or fullness of the buccal fat pads in the cheeks can create width that bone surgery would not fix. These are often treated with neuromodulators or buccal fat reduction, which are part of our cosmetic facial contouring options.
Because Dr. Elias is trained in both cosmetic and maxillofacial surgery, he can tell which layer is responsible, and he can treat either one. Your consultation includes a hands-on examination and, when bone surgery is being considered, 3D cone beam CT imaging so the recommendation is based on what is actually beneath the skin.
What this page covers
Facial Contouring Procedures
Skeletal contouring procedures can be performed individually or combined into a single plan that reshapes the upper, middle, and lower face in proportion.
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V-Line Surgery
Combines chin narrowing with reduction of the jaw angles so the lower face tapers smoothly from the cheeks to the chin, creating a slimmer, softer outline when viewed from the front.
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Jaw Reduction
Mandibular angle reduction removes a flared or square jaw corner, while outer cortex reduction thins the outer layer of the jawbone to narrow the lower face as seen from the front.
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Facial Slimming
A slimmer face may call for bone reduction, soft-tissue treatment such as masseter reduction or buccal fat removal, or both. We identify the true source of width before recommending surgery.
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Chin & Jaw Contouring
When the concern is the chin's projection, length, or position, or the definition of the jawline, our chin and jaw surgery guide explains sliding genioplasty and related procedures.
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Cheekbone Reduction
Zygoma reduction repositions prominent cheekbones and cheekbone arches inward to narrow the widest part of the midface, usually through incisions inside the mouth and a small hidden incision near the hairline.
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Facial Implants
Where the facial frame needs more structure, implants can add definition to the cheeks, jaw angles, or chin. Custom implants designed from your CT scan may suit complex or asymmetric cases.
Planning in Three Dimensions
Skeletal contouring is measured in millimeters, and small differences show. Planning uses cone beam CT imaging and digital surgical planning, part of our surgical technology and accredited facility, to map bone thickness, tooth roots, and the paths of the nerves before any incision is made. That map guides how much bone can be safely removed or repositioned and helps keep both sides of the face symmetric. Photographic analysis alongside the imaging shows how each proposed change relates to your other features, so you and your surgeon share the same goal before surgery day.
Nerve Safety, Risks, and Recovery
The jaw carries the inferior alveolar nerve, which provides feeling to the lower lip, chin, and teeth, and the cheekbone lies near branches of the facial nerve. Careful planning reduces risk, but temporary numbness of the lip and chin is common after jaw reduction and V-line surgery and usually improves over weeks to months. Lasting numbness, asymmetry, contour irregularities, and soft-tissue sagging of the cheek after zygoma reduction are uncommon but possible. Dr. Elias reviews these risks openly at consultation.
Skeletal contouring is typically performed under general anesthesia in our AAAHC-accredited Pasadena surgery center. Swelling is more pronounced than after soft-tissue surgery. Many patients return to desk work in about two to three weeks, follow a soft diet for a period, and see the final outline refine over several months as the last of the swelling resolves. Some patients combine contouring with facial feminization surgery or other facial procedures.
Why Cosmetic Doc
Why Choose Us for Facial Contouring
Reshaping the facial skeleton safely depends on training, planning, and judgment. Here is what you gain at our practice.
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Facial Skeleton Expertise
Board certification in oral and maxillofacial surgery and years of reconstructive work at the Cleveland Clinic give Dr. Elias deep familiarity with operating on the bones of the face.
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Precise 3D Planning
Cone beam CT imaging and digital planning measure bone and locate nerves before surgery, so each reduction is planned to a specific, safe depth and kept symmetric.
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Bone and Soft Tissue
Because Dr. Elias treats both layers, you are not steered toward bone surgery when muscle or fat is the real cause of width, or toward fillers when bone is.
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Harmony Over Extremes
The aim is a face that looks balanced and still recognizably yours, not an exaggerated outline that fights the proportions of your features.
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Candid Risk Discussion
Nerve changes, swelling, and recovery time are explained plainly at consultation, so you make your decision with realistic expectations and no surprises.
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Accredited Surgery Center
Skeletal contouring is performed in our AAAHC-accredited Pasadena ambulatory surgery center, where Dr. Elias is Medical Director, with full general anesthesia monitoring.
How Much Does Facial Skeletal Contouring Cost?
Your fee depends on which areas are treated and how, and you will receive a personalized, written quote after your consultation. The main cost factors are:
- Procedures and technique: Jaw reduction, cheekbone reduction, V-line surgery, and custom implants each involve different operating times and complexity.
- Anesthesia: Most skeletal contouring requires general anesthesia, and the length of surgery affects the overall investment.
- Facility: Surgery in our accredited on-site surgery center is often more cost-effective than a hospital setting.
- Combined procedures: Treating several areas at once changes the total, while allowing you a single recovery.
Facial skeletal contouring for cosmetic reasons is elective and generally not covered by insurance. We accept cash, checks, major credit and debit cards, and financing plans.
Schedule Your Facial Contouring Consultation
Patients travel to Cosmetic Doc from across Los Angeles for facial skeletal contouring with a surgeon trained in the facial skeleton. Schedule your consultation at our Pasadena office, home to our accredited surgery center, or our Sherman Oaks office, and see how a thoughtfully planned change to your facial frame could look.
Questions patients ask
Facial Skeletal Contouring FAQs
What is V-line surgery?
V-line surgery reshapes the lower face into a tapered outline by narrowing the chin and reducing the jaw angles, sometimes along with the outer layer of the jawbone. It is typically performed under general anesthesia through incisions inside the mouth, so there are no visible scars on the face, and it is planned using 3D imaging.
Will facial contouring surgery affect sensation in my face?
Temporary numbness of the lower lip and chin is common after jaw reduction and V-line surgery because the nerve inside the jaw lies close to the surgical area. Feeling usually returns gradually over weeks to months. Permanent changes are uncommon but possible, and 3D planning helps Dr. Elias keep bone cuts a safe distance from the nerve.
How long does swelling last after skeletal contouring?
Swelling after facial bone surgery is more pronounced than after soft-tissue procedures. Most visible swelling eases over the first two to three weeks, when many patients return to desk work. Residual swelling continues to resolve for several months, and the final outline of your face becomes clear gradually as it settles.
Can injections or buccal fat removal slim my face without surgery?
Sometimes. If your width comes from enlarged chewing muscles, neuromodulator injections can slim the jaw over time, and buccal fat reduction can refine full cheeks. If the width comes from bone, those treatments cannot change it. Dr. Elias will examine you, and use imaging if needed, to identify which layer is responsible.
Will cheekbone reduction make my cheeks sag?
Reducing the cheekbone changes the support beneath the cheek soft tissue, so some descent is possible, particularly in patients with looser skin. Careful technique, secure fixation of the repositioned bone, and appropriate patient selection help reduce this risk. Dr. Elias will assess your skin and soft tissue and discuss your individual risk at consultation.
Are the results of facial skeletal contouring permanent?
Bone that is removed or repositioned does not grow back, so the structural change is long lasting. Your face will continue to age naturally, with soft tissue gradually changing over the years, and some patients later choose soft-tissue procedures to refresh the result while the underlying framework remains in place.
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Your Choice for Expert Cosmetic Surgery in Pasadena & Sherman Oaks
Cosmetic Doc delivers board-certified cosmetic surgery with care, compassion, and artistry. From facelifts and rhinoplasty to body contouring, Dr. Husam Elias pairs dual MD/DMD training with an on-site AAAHC-accredited surgery center for the safest, most natural-looking results. Contact our Pasadena or Sherman Oaks office today to schedule your consultation.