**1. Introduction**

Changes in the esthetic appearance of the face is highly depended on the bony structures of the facial skeleton, including the malar-midface region, nose, and chin. Alterations of soft tissue and skin alone will not satisfy all of our aesthetic demands. Multiple factors such as skin (texture, color, thickness and...), soft tissue (symmetry, composition, location and...) and facial bony contours (size, shape, location, symmetry and...) contributes to creating esthetically appealing appearance of the face.

Since many years ago numerous surgical and office based techniques have been introduce to augment, reduce or refine the most projected points of the face such as cheek, chin, nose, Paranasal area, angle of the jaw..According to the literature the techniques can be classified to: 1) Office based or non-invasive techniques; such as fillers injection, facial lipostructure or facial liposuction which modified the soft tissue coverage of the facial skeleton.2) Facial prosthesis. 3) Maxillofacial osteotomies. Based on our knowledge the first and second group have been considered more in the literatures and text book of the Oral and Maxillofacial Surgery (OMFS) or Plastic Surgery, it is perhaps related to the more complications of the osteotomy techniques or easiness of the office –based one. OMFS are familiar with orthognatic surgeries and their skill in this field can help them to plan the third one,especially in cases whom the long term results should be considered. In current chapter we reviewed the esthetic osteotomy techni‐ ques of the facial skeleton and introduce a surgical techniques for management of the most projected points of the face namely:

#### **• Chin modification**

Reduction genioplasty

© 2015 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

#### **• Paranasal modification**

Piriform augmentation osteotomies

#### **• Mandibular Angle modification**

Angle augmentation osteotomies

Angle reduction oeteotomies

#### **• Malar modification**

Malar augmentation osteotomies

Malar reduction osteotomies

**• Forehead modification**

Frontal Bossing reduction techniques
