Types of Plastic Surgery to Improve a Long Face | Bone Cutting and Non-Surgical Cosmetic Procedures Explained

"Every time I look in the mirror, my face looks vertically long and it bothers me…" Do you have this kind of concern?

The causes of a long face impression involve a complex interplay of various factors such as bone structure, aging, and lifestyle habits, so the approach differs depending on the cause.

This article explains in detail the main causes of a long face appearance.

We also introduce aesthetic medicine approaches to improve a long face, so if you are concerned about the length of your face, please use this as a reference.

Main causes of a long face appearance

First, let us introduce the main causes of a long face impression.

Influence of heredity and innate bone structure

One of the root causes of a long face is genetics and innate bone structure. The following skeletal characteristics can make the face appear longer.

• The upper and lower jawbones are long and narrow in width
• The distance from the eyes to the mouth is long (elongated mid-face)
• The lower jaw protrudes forward or is long (underbite/prognathism)

Sagging of Tissues Due to Aging

For those who feel "I never noticed this when I was younger…", the face may appear longer due to the following causes.

• Decreased collagen and elastin cause the cheeks to sag and appear elongated
• Weakened facial expression muscles around the mouth can no longer support facial fat, causing the face to elongate downward
• Aging causes the jawbone and cheekbones to shrink, leaving excess skin that results in sagging

Facial Imbalance Caused by Lifestyle Habits

Daily habits and posture can cause the face to appear longer.

If a posture of hunching or forward head posture continues, the muscles under the chin and around the neck relax, promoting sagging and making the facial line more prone to distortion.

Additionally, if the jaw muscles (masseter) become overdeveloped due to clenching or grinding of teeth, the jaw angle becomes prominent and emphasizes the facial line, which may relatively make the face appear longer.

【Bone Surgery】Cosmetic Surgery to Improve a Long Face

"Bone surgery" that directly approaches the skeletal structure itself can be expected to fundamentally improve a long face caused by genetics or innate bone structure.

Le Fort Type 1 Osteotomy + Sagittal Split Ramus Osteotomy (SSRO) Treatment

The combination of "Le Fort Type 1 Osteotomy," which approaches the upper jawbone, and "Sagittal Split Ramus Osteotomy (SSRO)," which approaches the lower jawbone, forms a "bimaxillary surgery" that can balance the facial contour associated with a long face appearance.

By moving and repositioning both the upper and lower jaws, comprehensive improvement including the facial line and bite can be expected.

• Downtime: Swelling and bruising are most noticeable for 2–3 days after surgery. They settle within about 1 month, and full recovery takes approximately 6 months.
• Risks/Side effects: Possible complications include swelling, asymmetry, bruising, infection, scarring, pigmentation, foreign body reaction, pain, numbness, sensory abnormalities, hair loss, tissue necrosis, vision impairment, facial nerve damage, allergic reactions, and shock reactions.

Learn more about "Le Fort Type 1 Osteotomy + Sagittal Split Ramus Osteotomy (SSRO)"

Small Face / Facial Contouring by Jaw Angle, Cheek, and Chin Osteotomy (3-Point Contouring)

The small face / facial contouring surgery by jaw angle, cheek, and chin osteotomy (3-point contouring) is a procedure that reshapes protruding bone structures (jaw angle, cheekbones, chin) to improve the balance of the facial line and achieve a more refined contour.

The goal is not only to improve the appearance of a long face, but also to harmonize the overall facial balance. By addressing all three areas, a more natural and well-balanced result can be expected.

• Downtime: Swelling and bruising are most noticeable for 2–3 days after surgery. They settle within about 1 month, and full recovery takes approximately 3 months.
• Risks/Side effects: Possible complications include swelling, asymmetry, bruising, infection, scarring, pigmentation, foreign body reaction, pain, numbness, sensory abnormalities, hair loss, tissue necrosis, vision impairment, facial nerve damage, allergic reactions, and shock reactions.

Learn more about small face / facial contouring by jaw angle, cheek, and chin osteotomy

Cosmetic Procedures to Balance Facial Features

Depending on the cause, a long face may be improved in appearance by balancing facial features.

Lip Lift (Philtrum Shortening)

Lip lift (philtrum shortening) is a procedure that removes a few millimeters of skin beneath the nose to shorten the distance between the nose and lips, improving overall facial balance.

It is especially effective for those with a long mid-face, and can also be expected to create a brighter impression around the mouth.

• Downtime: Swelling and bruising are most noticeable for 2–3 days after surgery. They gradually settle within 1–2 weeks, and fully resolve within about 3 months.
• Risks/Side effects: Possible complications include swelling, scarring, redness, pain, bruising, edema, numbness, deformity, and allergic reactions.

Learn more about lip lift (philtrum shortening)

Mid-Face Lift

A mid-face lift is a surgery that can be expected to rejuvenate the entire face while simultaneously addressing dark circles under the eyes.

It can be expected to restore the mid-face, which has sagged due to aging, to its original position, giving the cheeks a natural volume and roundness, lifting the corners of the mouth, and creating a more three-dimensional appearance.

• Downtime: Swelling and bruising are most noticeable for 2–3 days after surgery. They gradually subside over 1–2 weeks and fully settle within about 3 months.
• Risks/Side effects: Swelling, redness, pain, bruising, edema, numbness, ectropion, infection, allergic reactions, etc.

Learn more about the Mid-Face Lift

Hyaluronic Acid Injection

By injecting hyaluronic acid, rather than simply filling wrinkles, it can be expected to add volume to the upper cheeks, significantly lift the overall center of gravity of the face, and reduce the visual impression of an elongated face.

• Downtime: Swelling and redness may occur but typically subside within 2–3 days.
• Risks/Side effects: Swelling, bruising, rare cases of vascular compromise (intravascular injection), infection, allergic reactions.

Learn more about Hyaluronic Acid Injection

Thread Lift

A thread lift involves inserting medical threads with special barbs (cogs) beneath the skin to physically lift sagging tissue back to its original position and tighten the mid-face.

• Downtime: Mild swelling and a feeling of tightness may last for a few days to about one week.
• Risks/Side effects: Swelling, redness, bruising, pain, pulling sensation, irregularities (improve over time).

Learn more about Thread Lift

Botox Injection

By injecting Botox into the muscles of the upper lip to relax them, it can be expected to slightly curl the lip upward (lip flip), making the area between the nose and lip appear shorter.

• Downtime: Swelling and redness may occur but typically subside within 2–3 days.
• Risks/Side effects: Bruising, mild swelling and tenderness, antibody formation from long-term continuous use, asymmetry or stiffness of facial expressions (can be improved with adjustments).

Learn more about Botox Injection

How to Choose a Clinic for Elongated Face Correction Without Regret

Treatments aimed at improving an elongated face are delicate procedures that greatly affect facial impression.

To avoid regret, choose your clinic carefully.

Does the clinic offer "tailored proposals" based on the individual cause of the elongated face?

Even among people with an elongated face, the cause varies — whether it is a long mid-face, a long lower jaw, or protrusion around the mouth area.

Therefore, it is important to choose a clinic that provides convincing proposals based on anatomical evidence, taking the overall facial balance into consideration.

Breadth of surgical experience in bone surgery and diversity of cases

A high number of surgeries alone is not sufficient to judge whether a clinic is trustworthy.

Please verify whether the clinic handles a wide range of cases, from individual procedures on the jaw, cheeks, and chin to combined surgeries such as double-jaw surgery and three-point facial contouring, as well as surgeries to balance the overall face (eyes, nose, etc.).

Also, when reviewing before-and-after photos, choose a clinic where you can check fine details of the results — not just the front view, but also whether the profile and diagonal lines are smooth and free of unnatural steps (secondary angles).

Surgery performed by a "board-certified plastic surgeon" and availability of "3D simulation"

Whether a "board-certified plastic surgeon" who is anatomically well-versed in the skeletal structure, muscles, nerves, and blood vessels of the face performs the surgery is a critical factor that directly affects risk reduction and the quality of results.

It is also important to check whether the clinic has the equipment to predict and plan procedures using 3D simulation with CT imaging.

Whether risks and limitations are explained openly and honestly

Whether the clinic has a doctor who thoroughly explains the disadvantages, such as each patient's skeletal limitations, risks like nerve paralysis, and the difficulty of the downtime period, is also an important criterion for making your decision.

By resolving any questions or concerns during a pre-operative consultation and choosing a clinic where you can discuss everything to your satisfaction, you can prevent post-operative regrets such as "this isn't what I expected."

Cases of long-face correction at KAI CLINIC TOKYO

Full face surgery

【Surgeon】
Mitsunori Harima
【Treatment details / Fees】
Bimaxillary surgery: ¥2,970,000 / Facial contouring 3 procedures: ¥2,530,000 / Ptosis correction + double eyelid surgery: ¥770,000 / Septal extension: ¥495,000 / Rhinoplasty (implant): ¥330,000 / Nasal tip plasty: ¥330,000 / Costal cartilage harvesting: ¥660,000 / Auricular cartilage grafting: ¥165,000 / Alar base surgery: ¥275,000
【Risks / Side effects】
Swelling, asymmetry, bruising, infection, scarring, pigmentation, pain, numbness, sensory abnormalities, bone deviation, oral contracture, facial nerve palsy, sagging, allergic reactions, etc.

View details of full face surgery

Facial contouring × sagging treatment

【Surgeon】
Ryo Takanashi
【Treatment details / Fees】
Facial contouring 3 procedures (1 year prior): ¥2,530,000 / Incisional lift: ¥2,200,000 / Pelican surgery: ¥1,100,000 / Transconjunctival Hamra: ¥495,000 / Lateral canthoplasty: ¥264,000
【Risks / Side effects】
Swelling, asymmetry, bruising, infection, scarring, pigmentation, pain, numbness, sensory abnormalities, bone deviation, oral contracture, facial nerve palsy, sagging, allergic reactions, etc.

View details of facial contouring × sagging treatment

If you want to improve a long face, please consult KAI CLINIC TOKYO

Concerns about a long face vary greatly depending on the cause and bone structure, and the appropriate approach differs accordingly.

At KAI CLINIC TOKYO, through careful consultations by board-certified plastic surgeons and 3D simulation using CT imaging, we propose customized treatment plans tailored to each patient's bone structure and desired outcome.

In addition, rather than simply performing procedures, we have a comprehensive post-operative aftercare system in place, and you can reach us at any time via our official LINE account if you have any concerns.

"I have a complex about the length of my face and really want to do something about it…"

If you have concerns like these, please feel free to consult our clinic.

Summary

The causes of a long-looking face vary widely—bone structure, aging, and lifestyle habits—and the appropriate treatment approach differs for each.

What matters most is "correctly identifying the cause of the long face and choosing the right treatment to match it."

To achieve this, receiving a thorough consultation at a clinic with anatomical expertise and an extensive track record of cases is the first step toward your ideal result.

At KAI CLINIC TOKYO, we sincerely address each patient's individual concerns and propose treatment plans designed to resolve them.

If you are troubled by a long facial appearance, please do not hesitate to consult our clinic.