Q: Dr. Eppley, I am interested in jawline liposuction. I posted my concern on Real Self a week ago and you were one of the surgeons that responded. You had said I was not a good candidate for facial contouring due to my prominent cheeks and you did not seem to recommend the liposuction. I wanted to inquire about this further because I had another consultation a few days ago and I was told I would be a good candidate for SmartLipo of the chin and jawline and that they could remove close to 90% of the double chin fat. The Vectra image I am attaching is very general. They told me the imaging does now show shadows very well and the end result would look better than what the Vectra would show. They showed me a few before and after pictures of prior patients and the results were dramatic.
My concern with the procedure is really whether or not I will obtain dramatic results that would justify having the procedure. I am not at my ideal weight but I am currently dieting and exercising to lose 15 pounds. The pictures you see are me at 170 pounds. At 155 pounds, the cheeks do slim down somewhat but the stubborn neck fat still lingers. The double chin is hereditary as my father has it. He is in his early 60’s and it is still very noticeable so that was another reason for me to look into this procedure as I don’t think any of that fat will atrophy any time soon for me.
After doing some more research, I am leaning away from doing any work on the buccal fat pad as I think it’s really the double chin that is making my face look bigger and the buccal lipectomy probably will not give me the result I am really looking for.
My goals are to get a tapered jawline and to reduce the overall size of my face. I’m 5’6″ and I believe my face looks a lot larger than it should on my frame.
I look forward to speaking with you about this.
A: When it comes to contouring any face/jawline with liposuction, its effectiveness is determined by three factors. First what is the natural tissue thickness of the patient’s face. Thicker skinned patients with fuller faces will get some positive changes but it will never be ‘dramatic’. Secondly, how much is the existing fat actually making a contribution to the lack of a defined jawline. In other words, if the fat is reduced will the natural jawline become more apparent or will it just look a ‘little better’. If you don’t have a good jawline bone structure to start with you won’t end up with one even if some fat is removed around it. Thirdly, how does the patient define a ‘dramatic’ result? What constitutes in their mind what a dramatic change in their jawline is.
Applying those three factors to you and your jawline….you have a thick tissued face with an acceptable but not a naturally strong bony jawline. I believe the best jawline result you could possibly get with facial and neck liposuction is what is shown by the Vectra imaging. It will not end up any better than that and that imaging may even be a little optimistic. If that result is what you would describe as ‘dramaric’ and a satisfying result that you will be pleased with the outcome of the procedure. But if you undergo it and expect the outcome to be better with a well defined and visible jawline then you will likely be disappointed. The reality is that your thicker and heavier facial tissues have limits as to how much they can be reduced and show any jawline definition.
This is what I would counsel you on if you were my patient. It is always better in aesthetic surgery to expect the least. What is the minimum type of result you would find acceptable to justify your efforts? Anything result better than the least will then be a bonus and will make for a very satisfying experience.
One final comment….such face and jawline liposuction is all you can do with your face to get some improved definition. There are no other procedures to consider at this point. Just don’t expect it to be a dramatic result with a well defined and sculpted jawline….that is simply not going to happen.
Dr. Barry Eppley