How Can I Make My Face Smaller With More Definition?

Q: Dr. Eppley, I’m interested in pursuing full facial liposuction to achieve a more defined, chiseled facial contour. I am hoping for a face that is smaller, sleeker, and more angular.I’m specifically looking for a comprehensive procedure targeting areas such as the jowls and cheeks to enhance overall facial definition. I am interested in facial fixes and angulation. I am open to your  recommendations.

Thank you for your time and expertise. I look forward to hearing from you.

A: Thank you for your inquiry and sending your pictures. The first concept to grasp is it is virtually impossible for most people to ever reduce their face into a more defined chiseled appearance and make it smaller.  Surgeons try this all the time with face and neck liposuction to create improved facial definition but it never works unless one has a naturally lean face with little fat…which means they don’t need surgery anyway.  The limiting factor is always going to be the thickness of the skin as well as the underlying soft tissues including muscle. In other words the two desires….improved definition and smaller…is not achievable.

This does not mean that liposuction or defatting does not have a role in improving facial contours…. but it is best thought of as an adjunctive procedure rather than having a major facial defining effect. In most patients seeking improved facial definition there has to be some form of augmentation either in the chin or cheek area. It is more achievable to augment one’s way into improve definition but one obviously has to be careful do not make the face substantially bigger in doing so. Thus the most effective approach for most patients is the combination of augmentation and reduction.

Another concept to grasp is that there is no such procedure as full face Liposuction. There are only two areas of the face in which to perform such fat reduction and that is in the cheek trampoline area (between the cheeks and the jawline) and in the neck. The the cheap defatting procedures include  buccal  lipectomy, perioral – lateral facial light liposuction and buccinator myectomies.

All of that being said in looking at your face I see merit in the three cheek defatting procedures possibly combined with a very small v-shaped chin augmentation (see attached imaging) there may also be a role for a very small cheek implants but I am more reserved about that in your face initially.

Dr. Barry Eppley

World-Renowned Plastic Surgeon