How Can I Get A More Defined Tapered Facial Appearance?

Q: Dr. Eppley, I have consulted with over six surgeons and am seeking a more defined, tapered, and striking facial appearance. I previously tried mid-cheek fillers to address flatness, but they added unwanted lateral width and puffiness rather than the sharp, forward projection I desired. My main goal is to permanently define the cheekbones and taper the lower face for a slimmer, more model-esque frontal view. Additionally, I have noticeable asymmetry: my right profile is sharp and well-defined, but my left side is more rounded with a heavier fat distribution that looks flat and wide from the front. I am open to a range of surgical options—including chin tapering, V-line contouring, or structural adjustments—and would appreciate your expert thoughts on the most effective approach to correct this asymmetry, eliminate the frontal flatness, and replicate the striking definition of my right profile across my entire face. I’ve gotten as far as I can with filler, but at this point, I want structural change so that I don’t have to continually tweak and maintain results and still feel underwhelmed.

A: Thank you for your inquiry and sending your pictures to which I can make the following comments:

1) You cannot reduce your way into improved facial definition. You can make structure smaller, but they will never have greater definition by so doing. You have to overcome the thickness of the overlying,soft tissues, which in most people requires some form of augmentation.

2) With augmentation to have a more V shaped jawline you need a discreet jawline implant to provide a bit of a longer but more narrow chin and a sleeper jawline. The same applies to the interior cheek areas, which must come forward, but not add width.

3) With facial asymmetry you need to determine why it  exists. The first step is to get a 3-D CT face scan, which will answer the question if there’s a skeletal basis for this a symmetry, whether it is purely soft tissue. Either way you are not going to improve the asymmetry by any form of reduction unless it is an exclusive soft tissue problem.

Dr. Barry Eppley

Plastic Surgeon