Lower Facial Reshaping
Q: Dr. Eppley, I am interested in lower facial reshaping surgery. My concerns regarding my chin/ jawline/ lower portion of my face are related to my profile and front views. From the side, I would like my jawline to look more defined, thinner. From the front, I would like my face to look thinner as well. I feel that my face from the front looks bottom heavy, I have jowls and marionette lines, even though I’m 36 and I am not, nor have I ever been, overweight- I’m 5’6” and weigh 125 lbs.
I’ve have had these issues even when I was young so I think it is more an underlying lack of bone. The chin is possibly too short and/or too recessed than an actual aging issue. I also think I have fatty deposits in my jaw/chin/neck area. I have looked into chin implants, sliding genioplasty, neck/chin/ jowl liposuction and buccal fat pad removal. I feel that while the research has helped me to better articulate my concerns, it also has me confused as to what treatments would be most appropriate for my specific case.
A: Thank you for sending all of your pictures for lower facial reshaping. The key determinant in deciding what procedures to do for any facial reshaping is what are the dimensional changes needed from a 3D standpoint. If you want your jawline to have more horizontal projection (side view), be thinner from the front view as well as adds some slight vertical length , you have narrowed it down to the only two procedures that are capable of making that type of dimensional chin change…a sliding genioplasty or a custom made chin implant. Neither chin augmentation method will address the perioral fullness or jowls so microliposuction of these areas would have to be added to it as well. The role of buccal lipectomy is for reducing fullness below the cheekbone as the fat pad does not extend down to the mouth or jawline level.
Dr. Barry Eppley