What Are Bone Grafts and How Do They Work?
Bone grafting allows surgeons to reshape and rebuild facial features by adding bone material to areas where bone is lacking. These techniques are used reconstructively following trauma or disease, as well as cosmetically to alter facial balance and proportion.
During a bone grafting procedure, the surgeon transplants bone tissue to a specific part of the patient’s existing bony structure. Once the graft is in place, it integrates with the surrounding bony tissue through two natural biological processes:
- Osteoinduction: the graft stimulates the body to produce new bone
- Osteoconduction: the graft material provides a scaffold for new bone formation
Bone grafting techniques have evolved in recent decades. Today, surgeons have access to cutting-edge materials and sophisticated techniques that deliver more predictable results with reduced recovery time and fewer complications.
What Are Common Cosmetic Applications of Bone Grafting for Asian Patients?
Our approach at Asian Plastic Surgery always considers the facial features, beauty ideals and other preferences common among Asian populations.
Where facial enhancement is concerned, some of the most popular requests include:
- Creating an oval or heart-shaped face (as opposed to square or rectangular)
- Augmenting a low or flat nasal bridge
- Enhancing the projection of a recessed chin
- Increasing projection in the mid-face
Bone grafting is one option for accomplishing these goals. Depending on the patient’s needs, goals and anatomy, our specialist plastic surgeons may recommend an alternative approach, such as facial implants or facial fat grafting.
How Does Bone Grafting Compare to Bone Reduction Procedures?
Both bone contouring techniques are used to enhance facial features—one by adding volume and the other by reducing it.
Bone Grafting
- Purpose: Adds volume and projection to specific areas
- Approach: Transplants bone from a donor area to the targeted area
- Common applications: Enhancing chin projection, improving nasal bridge height, balancing asymmetry
- Results: Creates more defined and prominent features
Bone Reduction
- Purpose: Reduces prominence of certain facial bones
- Approach: Reshapes existing bone structure through cutting or shaving
- Common applications: V-line surgery, cheekbone reduction, jawline reshaping
- Results: Creates softer features or a slimmer facial shape
How Does Bone Grafting Compare to Fat Grafting?
Bone grafting and fat grafting accomplish facial augmentation through different approaches and in different layers of facial tissue.
Bone Grafting
- Structure: Provides firm, structural support that maintains its shape
- Longevity: Results are permanent once the graft integrates
- Best for: Enhancing areas that benefit from solid, defined structure (chin, jawline, cheekbones)
- Procedure complexity: Typically a more involved surgical procedure and recovery; may require bone from a donor area
Fat Grafting
- Structure: Adds soft tissue volume that feels natural
- Longevity: Some resorption is expected; may require touch-ups
- Best for: Adding volume to softer facial areas or filling depressions
- Procedure complexity: Less invasive; requires liposuction from a donor area
How Does Bone Grafting Compare to Facial Implants?
Bone grafting and facial implants improve definition and symmetry by adding volume to specific areas using different materials.
Bone Grafting
- Integration: Becomes part of your natural bone structure
- Material: Uses natural or man-made biocompatible materials
- Customization: Can be precisely shaped to your anatomy
- Feel: Once healed, feels completely natural as part of your own bone
- Long-term stability: Minimal risk of shifting or extrusion
Facial Implants
- Integration: Remains a separate entity within your tissue (although can still be difficult to remove due to bone ingrowth over time)
- Material: Made from biocompatible materials like silicone or polyethylene
- Customization: Available in various sizes but with more limited customization
- Feel: May be detectable to touch, particularly in thin-skinned individuals
- Long-term stability: Some risk of shifting or complications over time
What Types of Bone Grafts Are Available?
Several types of bone grafts are used in plastic surgery. We'll help you weigh the options during your consultation.
Autografts
Autografts—bone harvested from the patient's own body—remain the gold standard in bone grafting. Common donor sites include the iliac crest (hip bone), mandible (jaw), calvarium (skull), tibia (shin bone) and ribs.
Pros:
- Highest compatibility with the patient’s body
- Superior integration potential
- No risk of disease transmission
- Good long-term stability
Cons:
- Requires a second surgical site
- Additional recovery and potential complications
- Limited amount of bone available
- Longer surgical time
Allografts
Allografts use bone tissue from human donors. They're particularly useful in cases where large amounts of grafting material are needed or the patient prefers to avoid having two surgical sites.
Pros:
- No second surgical site needed
- Available in larger quantities
- Shorter surgical time
Cons:
- Slightly lower integration rates than autografts
- Minimal (but not zero) disease transmission risk
- May take longer to incorporate into patient’s bone
Xenografts
Xenografts are derived from non-human species, with bovine (cow) sources being the most common. The materials undergo thorough processing to remove organic components while preserving the mineral structure that supports bone growth.
Pros:
- Readily available in various forms
- Excellent osteoconductive properties
- No need to harvest bone from the patient
- Lower cost compared to some alternatives
Cons:
- Lower integration rates than autografts
- Some patients may have cultural or personal concerns
- Processing quality and potential immune responses are important considerations
Synthetic Bone Substitutes
Synthetic bone substitutes are laboratory-created materials designed to mimic natural bone, including calcium phosphate compounds, bioactive glass and composite materials.
Pros:
- Unlimited availability
- Consistent quality and composition
- No risk of disease transmission
- Easy sterilization and storage
Cons:
- May lack the ability to stimulate bone formation (osteoinduction)
- Variable resorption and replacement rates
- Higher cost for advanced formulations
How Is the Bone Grafting Procedure Performed?
Bone grafting procedures vary depending on the area and graft type, but generally follow these steps:
- Pre-surgical planning: Detailed imaging helps our surgeons determine exact graft requirements
- Graft preparation: The selected graft material is prepared according to its type
- Recipient site preparation: The area receiving the graft is exposed and prepared
- Graft placement: The graft material is positioned and secured to the existing bone
- Closure: The site is closed with careful attention to blood supply and tissue coverage
Most bone grafting procedures are performed under general anesthesia. Surgical time varies from one to four hours.
Is Bone Grafting the Right Choice for You?
Bone grafting can be an excellent solution for those seeking long-term changes in facial balance and definition.
You may benefit from bone grafting if:
- You want more defined or prominent facial features
- You have facial asymmetry
- You need structural support for another procedure
- You’re seeking a permanent solution that becomes part of your facial structure
Bone grafting is not suitable for everyone. If you have a medical condition that affects bone healing, such as severe osteoporosis or chronic infections, you may need to explore alternatives.
Determining whether bone grafting is right for you starts with a professional evaluation. During your consultation at Asian Plastic Surgery, we'll discuss whether bone grafting can address your concerns and which type of bone graft is suited for your needs. Your surgeon will base their recommendations on factors such as the location and size of the targeted area, your bone contours and density, your personal health factors and your preferences regarding donor sites.
Request Your Consultation at Asian Plastic Surgery
Expertise matters. At Asian Plastic Surgery, your care is in the hands of Dr Quan Ngo, a Specialist Plastic Surgeon with decades of experience in reconstructive and cosmetic facial surgery.
Dr Ngo’s training spans Australia, the UK, France and Taiwan, with special focus in the Head & Neck region. Cosmetic bone-reshaping work has been of particular interest to him throughout his career.
We invite you to learn more about our qualifications and the bone grafting procedure by coming in for a consultation. You may request an appointment by filling out our enquiry form or calling 02 8962 9388.
