Can My Jaw Angles Be Reduced To Make My Face Look Less Square?
Q: Dr. Eppley, I had read online some of your comments about jawline reduction for square faces. So far, I have only seen jawlines that look like they have been cut and it looks unnatural and too short from the sides, and also, from the sides it shows no angles at all. I am therefore hesitating to do this surgery. Asymmetries (I wonder how that can happen since X rays are being done) and sagging skin. I am just looking for the angles (the whole jawline?) to be rounded off just enough so my face doesn’t look square; I have done Botox but it created some jowls and my face got hollow and it only reduced the masseter muscle, I had a hard time smiling too and the muscle would bulge when I ate.
What should I do to have a more feminine, natural, softer jawline? I want to avoid sagging skin too (I’m 42 years-old); will shaving only a bit would avoid this? Is it worth it then?
A: The key to jaw angle reduction is understanding whether jaw angle ostectomy (amputation) is needed or whether jaw angle outer corticotomy (width slimming) is needed. Unfortunately, the historic concept of jaw angle amputation persists and is commonly used, whether that is what the patient really needs or not. That is why you see faces, as you have described, that have had jaw angle reduction and look like they have no angles at all. Your jaw angles would need to be reduced using removal of the outer cortex only, thus reducing width but not losing the support of the bony angle completely. Your ‘failure’ with Botox injections indicates that the muscle is not the primary reason for the excessive contour. Whether reducing the outer cortex of the jaw angles is worthwhile depends on how much the bone is contributing to the flair that you have. The Botox treatments you had is a favorable indicator but it would be conclusively helpful knowing what the bone looks like as well. Therefore a simple AP facial/jaw x-ray view would be most helpful to decide either way if this procedure would be helpful.
Dr. Barry Eppley