How Can I Get A More Angular Lower Third Of My Face?

Q: Dr. Eppley, Hello I  have provided some pictures of myself. I would like to achieve a lower third similar to the men attached in the attached pictures.

My questions would be:

1)Is it possible for me, after surgery, to have that angular lower third?

2)What surgery would i need? I suspect i would need a custom jaw angle implant(after reading your website). 

3)I also have some “smaller” problems like jowls and some perioral mounds. Would those also be fixed by the skin stretching i would achieve after the jaw angle implants(if my assumption is correct)? 

4)Would fillers be a good idea for a “preview” of the result i would get after the implant?

5) Do I have other skeletal or soft tissue defects which i am missing? I am afraid of the idea of doing surgery and then finding out there are other things to improve. For example do you think i lack forward growth? 

6) I also think i have an asymmetry but i can not figure out if it is due to bone or soft tissue asymmetry. 

A: In answer to your jawline augmentation questions:

1) While model pictures provide ideal goals, what can realistically be achieved must be determined on each person’s face by predictive imaging which provides a general concept of the potential change. (see attached)

2) You are correct in that only a custom jawline implant can create that potential lower third of the face change.

3) Any jowls are usually completely eliminated by the implant augmentation. Perioral mound fullness requires microliposuction which is often done in combination with jawline augmentation.

4) Fillers do not provide the same type of jawline change that implants on the bone create, largely due to the volume differences. (e.g., 4 or 5 ccs of fillers does not create the same effect as a 12 to 15cc implant…which is what it would be for what you are trying to achieve)

5) One of the primary objectives of computer imaging is to see how changing one part of the face affects the others. That is the way to determining if other parts of the face are being ‘left behind’.

6) Almost all facial asymmetries have a significant skeletal basis for them.

Dr. Barry Eppley

Indianapolis, Indiana