Todd Hanna, MD, DDS, FACS

Todd Hanna, MD, DDS, FACS Oral & Maxillofacial Surgery, Aesthetic Face Jaw & Chin Surgery, Microvascular Head & Neck Reconstruction

11/25/2025

I think of the chin much like the nose of the lower face. It plays a central role in defining the lower facial third, and its intricate anatomy is closely related to the lips, similar to the nose. Some individuals may have isolated chin deficiencies; genioplasty or chin implants can address these. Conversely, weak chins may also be part of a broader jaw deficiency, requiring a combination of jaw surgery plus chin augmentation. Many individuals with weak chins or jaws also display soft tissue ptosis (looseness) in the buccal fat pads and submentum (area under the chin and jaw) due to inadequate structural support of the bone. Creative genioplasty techniques and addressing the soft tissue can effectively treat various conditions when jaw surgery is not indicated, or desired by the patient.

1 month post op upper eyelid   and subtle fat grafting of the     .  There is actually almost 3 years between these phot...
09/19/2025

1 month post op upper eyelid and subtle fat grafting of the . There is actually almost 3 years between these photos as this beauty has entrusted us with multiple other esthetic face and jaw procedures over the years. The eyelids are the “salt on the meal” so to speak. *The last photo reflects the eyelids during smile, which is something patients often note at consultation, but is rarely shown in before and after photos.

Lower   (after cancer removal  ).  Using creative soft tissue reconstructive techniques and core geometric principals we...
08/20/2025

Lower (after cancer removal ). Using creative soft tissue reconstructive techniques and core geometric principals we were able to reconstruct this defect with one stage, same day. Mouth opening and function is unchanged, scar is barely visible at 3 months.. and will get better and better still. Best part of the job ❤️

The beauty of the deep plane face lift, especially in younger patients, is that you can do a lot without looking like yo...
04/09/2025

The beauty of the deep plane face lift, especially in younger patients, is that you can do a lot without looking like you did a lot.

This is a very beautiful woman, and very young by facelift standards, who was previously highlighted on our page at 9 days post-op. She’s now 10 weeks out from her deep plane facelift. *This was not for aging, but to correct an issue that she had from acne scar treatment several years ago leaving her with prematurely heavy cheeks (see prior post for case details including bilamellar subcision component).

The red and blue circles identify landmark cheek scars that show us the vectors and degree of lifting. We removed almost 2 inches of skin per side in a vertical vector with zero tension, which is more than I would sometimes remove on even older patients with much more loose skin using non-deep plane techniques.

By releasing the facial ligaments within the deep plane, you’re able to passively reposition the facial tissues much more, without things being, or looking, pulled.

This is really the key to the natural esthetic of modern-day face lifting. Very happy for this gorgeous woman.

1 month post-op custom genioplasty.  This is a great example of exploring surgical options because, sometimes, there is ...
04/04/2025

1 month post-op custom genioplasty. This is a great example of exploring surgical options because, sometimes, there is more than one right answer.

Classically this would be a jaw surgery plus genioplasty case, which was my recommendation. She wanted the genioplasty only, so we had to find ways to achieve a meaningful projection (~1cm) while avoiding the pitfalls of large isolated chin advancements.

Gladly, we were able to achieve the desired chin projection to balance her lower face with her upper and middle thirds. All while creating elegant curves and angles between the lower lip-chin-neck — especially notable during smile. Sculptural and feminine. Very happy for this beauty ❤️

It was an honor to share our approach to facial esthetic and orthognathic surgery with the legendary Tim Turvey and the ...
03/28/2025

It was an honor to share our approach to facial esthetic and orthognathic surgery with the legendary Tim Turvey and the amazing team at UNC . The warmth of this institution reminded me of my own residency days at . Tim is a trailblazer in orthognathic and cleft craniofacial surgery in the states, and grew up just a few miles away from where I grew up in New York. After training with Paul Tessier in Paris, Tim has built an epic career filled with contributions and accolades at UNC. Truly an honor for myself and 🙏 . Special thanks to my tour guides and derricknelson

Obstructive sleep apnea (OSA) treatment with maxillomandibular advancement (MMA). This is essentially orthognathic (doub...
02/14/2025

Obstructive sleep apnea (OSA) treatment with maxillomandibular advancement (MMA). This is essentially orthognathic (double jaw) surgery and genioplasty using large advancements with the primary focus was on increasing the airway, rather than esthetics or occlusion. Our particular treatment philosophy however, prioritizes esthetics and occlusion, equally with airway.

*Airway volumetrics from CT scans do not diagnose OSA or definitively reflect cure, but they are a very helpful metric to assess progress. A sleep study, specifically AHI (Apnea Hypoxia Index), is needed for diagnosis.

These cases have gotten a bad wrap for undesirable esthetics due to distortion of nose, mouth and chin, but when performed thoughtfully, they can actually make patients look and feel profoundly, younger, healthier, and more attractive. Breathe better, look better, feel better.

Great guy.. very happy for him

Long term follow up with doublejawsurgery genioplasty and closed rhinoplasty for class 3 underbite, flat labiomental fol...
02/13/2025

Long term follow up with doublejawsurgery genioplasty and closed rhinoplasty for class 3 underbite, flat labiomental fold, and dorsal hump. The subtleties of this case include, bringing the lower lip back, to the level of (or slightly behind) the upper lip (when looking from side profile), creating a slightly deepened labiomental fold (inward curve between the lower lip and the chin), adding structural support to the upper lip and cheeks, and softening the nasal bridge, and controlling elevation of the nasal tip (supra-tip break) while preventing nasal base widening. Subtle does not always mean simple.

Bi-lamellar facelift (deep plane and sub-cutaneous plane). Early post op photos at post-op day 9 to highlight what recov...
02/02/2025

Bi-lamellar facelift (deep plane and sub-cutaneous plane). Early post op photos at post-op day 9 to highlight what recovery can look like. This is a fix/revision case of a beautiful young woman who had fat grafting and other non-surgical treatments for cheek scars several years ago elsewhere. It left her with premature heaviness and skin laxity in the mid and lower face. “Iatrogenic” doughy cheeks. We needed a deep plane approach to adequately release and elevate the extensive grafted fatty tissue in the cheeks, and we needed a subcutaneous plane approach to sub-incise the cheek scars. The bi-lamellar lift (dual plane) accomplished both objectives, and additionally allows for dual vectors of SMAS and skin (as opposed to composite deep plane lift).

HFJ family (missing Keldsy and Lis). 2024 was an incredible year for us filled with growth and milestones. We have grown...
01/11/2025

HFJ family (missing Keldsy and Lis). 2024 was an incredible year for us filled with growth and milestones. We have grown this practice from a single operatory and a coat closet for an admin office, to a state-of-the-art multi-unit surgical facility. Ever-growing.

This growth is possible because of the dedication and efforts of the truly superb people within our little work family, and within our network of colleagues and trusted patients—I am grateful for each of you and our growth is a reflection of that gratitude.

The most important skill, as a surgeon or anything else, is being able to attract superb human beings. Set the bar high and the superb ones will find to you. Those not up for it will w**d themselves out. Our people are our greatest success.

Wishing each of you a healthy prosperous and joyful 2025! May your dreams become a reality ❤️

Post-Op Day 5 from subnasal lip lift. Close up high definition photos taken immediately after suture removal, hence the ...
12/21/2024

Post-Op Day 5 from subnasal lip lift. Close up high definition photos taken immediately after suture removal, hence the red spots. This incision will flatten, pink will fade, and it will be near invisible, even close up, in weeks to months.

Factors that influence how a scar heals can be grouped into 3 categories:

1. Technical elements such as carefully designing making and closing the incision, and handling the soft tissue gently. This includes suture choice and closure techniques. These are things the surgeon and team can control.

2. Genetic or systemic elements including tendencies towards hypertrophic scars or keloids, certain medications, hormonal imbalances, and infections can all affect scars. These are things that may or may not be in the control of the patient or the surgeon.

3. Postoperative and environmental elements. How the wound is cared for after surgery. Using silicone and sunblock are the two most widely accepted methods to encourage a well-healed scar. Avoidance of sun is probably the most critical. These are things that patient can control.

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