Q: Dr. Eppley, I am a 28 year old woman with slim build. I have been unhappy with my facial structure and feel that the lower half is “heavy” and undefined while from cheekbones up, it is narrow and flat. I am considering buccal fat removal to even out my lower cheek/ jaw. I wan a slimmer face as well as a more delicate mouth and rounder forehead. A more heart-shaped face, as opposed to my triangular one (bottom heavy) What is your opinion? Thank you!
A: This is what I had thought your concerns were. From a lower face standpoint, what makes your face heavy is the wide lower jaw/masseter muscles. This is due to your ethnicity as you know. There is no type of fat removal, buccal lipectomy or otherwise, that is going to make that change as the problem is not one of fat. It is due to your musculoskeletal structure. Typical options include repeated Botox injections to the masseter muscle to cause it to shrink/atrophy and/or bony jaw angle/inferior border mandibular reduction. There are advantages and disadvantages to either approach which is demonstrated in their injectable (non-surgical) vs surgical approach. From a forehead standpoint, a rounder and more convex forehead is achieved through an augmentation material using a hydroxyapatite cement to build it out. (forehead augmentation) This is done through an open scalp approach.
When these procedure are combined (upper and lower face), this is how a truly effective facial shape change can be achieved.
Dr. Barry Eppley