Facial Skeletal Surgery in West Palm Beach, FL

Why the bone comes first

A patient asks about their nose, and the measurement that is actually off is the chin. A patient asks why their facelift looks pulled, and the answer is that the tissue was repositioned onto a skeleton that could not support it. A patient has had filler along the jaw for four years and still has no defined angle, because an angle is a bony structure and filler is not.

These are not unusual cases. They are the ordinary consequence of treating the face as a soft-tissue problem when the face is built on a frame.

Upper/lower jaw and chin advancement example. Individual results vary.

A plan for your facial balance

Dr. Carlotti brings 25 years of cosmetic surgery experience to planning changes in facial shape and proportion. Your consultation considers the whole face, your goals and the relationship between appearance and function.

The plan may involve chin surgery, facial implants or corrective jaw surgery, depending on the findings. Read about Dr. Carlotti's experience and training.

Procedures in this group

Facial Skeletal Surgery

Custom Jawline Implants

Patient-specific implants designed from your own CT scan — definitive jawline structure rather than approximate off-the-shelf shapes.

Chin Augmentation & Genioplasty

Two very different operations for the same complaint — and a clear account of when each one is right.

Orthognathic (Corrective Jaw) Surgery

Repositioning the jaws themselves — for bite, for airway, and for the facial balance that follows from both.

Facial Implants

Building structure at the level where facial shape actually comes from — the bone.

Questions about facial skeletal surgery

Why does the facial skeleton matter in cosmetic surgery?

Bone determines where light falls on a face — the cheekbone, the orbital rim, the mandibular border, the chin. Soft tissue drapes over that frame. Repositioning soft tissue over a frame that has lost projection produces a fuller face rather than a younger one, which is why some facelifts and some volumizing add years instead of removing them.

What will Dr. Carlotti evaluate at my consultation?

Dr. Carlotti reviews your goals, facial proportions, chin and jaw position, bite and soft tissue. Imaging may be recommended when it will help clarify the plan. He explains the available options, their limitations and the recovery involved.

Do I need an implant or jaw surgery?

If the bite is normal and the concern is contour, an implant changes shape. If the jaws are positioned incorrectly relative to one another — underbite, significant overbite, open bite, airway compromise — orthognathic surgery repositions the bone and corrects both function and appearance.

Can filler do the same thing as a facial implant?

No. Filler sits in soft tissue above the bone. It can add a little volume but cannot create an angle, a border or projection at a defined point, and large volumes tend to read as heaviness rather than structure.