Bone technique
A controlled cut is made inside the mouth, the chin segment is moved and fixed. It can advance, set back, raise, lower or recenter the chin.
Facial surgery · Tunis
Facial surgery
Seven procedures on one page to understand goals, limits, scars and recovery — clearly, without promises.
General information. Surgical indications are decided by a qualified surgeon after assessment.
01 · Genioplasty - chin surgery
Balance the profile, do not hide a jaw.
Genioplasty changes the position, projection or height of the chin. Before deciding, the surgeon must distinguish an isolated chin position from a lower-jaw and bite problem.
The essential filterIf the teeth do not meet correctly or the whole lower jaw is set back, orthodontic assessment and orthognathic surgery may be needed. Advancing the chin alone does not correct the cause.
Implant
A biocompatible implant can correct simple projection. It introduces a foreign device with possible displacement, infection or bone resorption.
Preparation
Profile analysis, dental examination, imaging and good oral health are essential. Swelling and numbness may last for months.
Result and scar
The benefit is read mainly in profile and settles over several months. An internal approach leaves no visible scar; an external approach leaves a small mark under the chin.
Risks
Numbness of the lip and chin, infection, asymmetry, under- or over-correction, dental-root injury and implant-specific complications must be discussed.
Frequently asked questions
Questions patients ask us.
An implant suits simple projection corrections; bone allows more complex correction and avoids a foreign body. The surgeon recommends according to the case.
With an internal approach, no visible scar. With an external approach, a small scar lies under the chin.
Temporary numbness is common and can last weeks to months. Permanent injury is exceptional.
Yes, often. Both procedures affect the balance of the facial profile.
Tell the surgeon. The problem may require orthodontic and jaw treatment rather than genioplasty.
02 · Canthopexy
Support the eyelid, without promising a filter.
Canthopexy tightens and repositions the outer eye corner to support the lower eyelid. It is most often combined with lower blepharoplasty and is not a minor gesture.
Set expectations honestlyThe aesthetic effect is modest. Excessive traction can change the eye shape, affect closure and look artificial. Retouched images are not a surgical reference.
Indications
Lower-lid laxity, separation from the globe, a drooping outer corner, prevention of retraction after surgery or asymmetry.
Technique
The ligament is tightened and fixed to the orbital rim. Canthoplasty is more extensive and re-inserts the ligament for major laxity.
Recovery
Swelling, bruising, tightness, dryness and watering are common. Slight initial overcorrection relaxes over several weeks.
Assessment
Lid tone, globe prominence, cheek support, dry eye and previous eye surgery affect feasibility and stability.
Urgent signs
Severe eye pain, reduced vision, sudden tight orbital swelling, inability to close the eye or pus require immediate contact.
Frequently asked questions
Questions patients ask us.
No. The effect is modest and unlike retouched images. Excessive traction can look artificial and disturb the eye.
Most often it accompanies lower blepharoplasty and supports the eyelid.
Partial relaxation over time is possible because the ligament retains some elasticity.
A slight initial overcorrection is intentional and relaxes over several weeks.
Canthopexy tightens the ligament in place; canthoplasty detaches and re-inserts it. The latter is more extensive.
03 · Face and neck lift
Reposition tissue, do not pull the skin.
A facelift repositions deeper face and neck tissues, then removes the resulting excess skin. It redraws the jawline and neck, but does not change skin quality or restore lost volume.
What it does not doIt does not erase fine lines, pigmentation or sun damage, automatically treat eyelids, or stop ageing. Fat transfer, blepharoplasty or skin treatments may complement it.
Who may benefit
Facial or neck laxity, loss of the oval, jowls, deep folds and realistic expectations of a natural rejuvenation.
Techniques
Deep-plane treatment, including the SMAS when indicated, is adapted to laxity. A small incision under the chin may complement it.
Recovery
Swelling, bruising and tightness change over several weeks. The minimum stay and return flight must be decided with the surgeon because early haematoma can require urgent care.
Scars
Scars lie around the ear and sometimes in the hairline. They fade but do not disappear. Hair loss along a scar is possible.
Risks
Haematoma, infection, skin healing problems, sensory changes, facial nerve injury, asymmetry and insufficient result should be discussed.
Frequently asked questions
Questions patients ask us.
A lift moves the starting point back but does not stop ageing. Duration varies with skin, lifestyle and sun exposure.
Recovery is visible for several weeks. The final result should be discreet; a good lift does not announce itself.
No. It repositions tissues. Fine lines and skin quality need other treatments.
The eyelids are not treated by a facelift. Blepharoplasty can be combined.
It depends on how much social recovery you need. Several weeks are usually needed before bruising is no longer visible.
04 · Rhinoplasty
A nose adapted to the face, not copied from a photo.
Rhinoplasty changes the nose according to anatomy, skin thickness, symmetry and balance with the lips and chin. Breathing difficulty must be reported.
Results take timeWhen the splint comes off, the nose is swollen, raised and often disappointing. The tip can take a year or longer to define. Perfect symmetry cannot be guaranteed.
Indications
Proportion, hump, tip, deviation or a wish to harmonise the nose with the face, with realistic expectations.
Approach
Closed or open approach and work on bone, cartilage or turbinates depend on the correction. A retouched image cannot predict the result.
Recovery
A blocked nose is often more troublesome than pain. Splint, bruising, swelling and impact precautions evolve over weeks.
Breathing
Breathing difficulty may require a functional procedure as well. When anatomical, rhinoseptoplasty can be considered.
Risks
Bleeding, infection, irregularities, asymmetry, temporary smell changes, an unsatisfactory result and possible revision are discussed.
Frequently asked questions
Questions patients ask us.
The main change appears after several months, but the tip can take a year or longer to define.
A direction can be discussed. The result depends on your anatomy and skin thickness, not on a model.
Pain is usually moderate. Nasal blockage during the first days is often the hardest part.
It is more common than after some other procedures, usually for a minor adjustment, and never before one year.
Tell the surgeon. A functional procedure may be combined; see the rhinoseptoplasty section.
05 · Rhinoseptoplasty
Improve breathing and shape while separating the goals.
Rhinoseptoplasty combines a functional procedure on the septum or turbinates with a possible aesthetic procedure. ENT assessment checks the true source of obstruction.
Breathing firstAn obstruction caused by allergy or inflammation is not necessarily corrected by surgery. A proper ENT work-up prevents treating the wrong cause.
Functional part
Septoplasty straightens the septum without changing the outside of the nose. Turbinates may be treated when indicated.
Aesthetic part
The bridge and tip are adapted to the face. A long-standing deviation may come with facial asymmetry.
Recovery
Internal swelling, crusting and blockage last for weeks. The tip may take a year or longer to define.
Insurance
In some countries the functional part may be covered under conditions and prior approval. Check before planning treatment abroad.
Risks
Partial improvement, septal perforation, adhesions, dryness, bleeding, infection, irregularities and possible revision are explained.
Frequently asked questions
Questions patients ask us.
Improvement is common when the cause is anatomical, but it takes weeks and may remain partial if allergy persists.
Yes, this is septoplasty. It does not change the outside appearance of the nose.
Internal swelling and crusts during the first weeks temporarily obstruct the nose.
In some countries the functional part may be covered under conditions and prior approval. Check before planning treatment abroad.
The main change appears after several months; the tip can take a year or longer.
06 · Buccal fat removal
An irreversible gesture for a modest effect.
Buccal fat removal removes part of a normal deep cheek fat structure. It may refine the lower cheek, but it does not create a jawline.
The non-negotiable pointBuccal fat does not grow back. The face naturally loses volume with age, so an early or poorly selected removal can create a hollow, aged appearance later.
Narrow indication
Truly full lower cheeks, stable weight, no existing hollowing and realistic expectations.
Internal approach
A small cheek incision allows partial removal. The facial nerve and parotid duct pass nearby.
Recovery
Cheeks are initially more swollen than before. Soft food, mouth rinses and careful hygiene are needed.
Result
The change is modest and visible after several months. It does not replace weight loss or treat muscular or bony fullness.
Risks
Asymmetry, infection, haematoma, facial-nerve weakness, salivary-duct injury and excessive or insufficient result are possible.
Frequently asked questions
Questions patients ask us.
No. Removed buccal fat does not regrow. A later fat-transfer correction cannot recreate the original structure.
No. It refines the lower cheeks and does not redraw the jawline.
This is a real risk: the face naturally hollows with age and that loss will add to the volume removed.
No external scar is visible because the incisions are inside the mouth.
After several months. The first weeks look like the opposite because the cheeks are swollen.
The procedure will not help if fullness is caused by weight, muscle or bone, while remaining irreversible. Clinical examination is essential.
07 · Facial fat transfer
Restore volume with your own fat.
Fat is harvested from another area, prepared and reinjected in tiny amounts into the temples, cheeks, tear troughs, lips, chin or jawline.
Two limits to understandSome fat disappears unpredictably and a second session is common. Fat transfer fills; it does not lift loose tissue. A facelift repositions.
Harvest
Donor areas may include the abdomen, waist, knees or thighs. Without enough reserve, the plan cannot be performed.
Micro-injection
Prepared fat is placed in tiny deposits and several layers to encourage blood supply and limit irregularity.
Recovery
The face looks overfilled and sometimes asymmetric at first. Avoid pressure, massage, heat, sun and sport as instructed.
Result
Surviving fat is durable but follows weight changes. The final result takes months and ageing continues.
Specific risks
Resorption, asymmetry, nodules and irregularities can occur. Sudden injection pain, visual change or blanching skin requires immediate contact.
Frequently asked questions
Questions patients ask us.
Fat transfer uses your own tissue and surviving fat can last, but it requires surgery and unpredictable resorption. Injectable fillers are simpler but absorbable.
Fat that survives is lasting, but it follows weight changes and ageing continues.
Often a second session is offered to complete the result. Plan it in the calendar and budget from the start.
No. Fat transfer fills; a facelift repositions. Filling loose tissue without repositioning can make the face look heavier.
Markedly for several days, visibly for several weeks, and the final appearance takes several months.
Your project
A first conversation,
without pressure.
Punica Med coordinates and supports your journey. Medical assessment and surgery remain the responsibility of qualified healthcare professionals.