Q: Dr. Eppley, I was wondering if I can send pictures for your opinion of a chin pad re-suspension/jaw line augmentation. I have taken some pictures from different angles. I love the fact that you are also a Doctor in dental medicine, and you have a vast understanding of the chin and mandible bones, and have plenty of experience re-suspending the chin muscles to correct the appearance of “witch’s chin”, producing natural looking results as well. I am 46 years old and a little more heavy by 10-15 pounds so the contrast between my round face and triangle chin is now more evident. My chin and pre-jowl area are looking worse as I age. I’m looking forward for your opinion.
A: I have looked at your chin/jawline issues and there are two different directions to go. The first is to simply resuspend the chin pad back up with submental liposuction. (illustrated in Facial prediction 2) The other approach is to build the chin and jawline out with submental liposuction. (illustrated in Facial Prediction 1) I think you have always had a smaller chin being a small women so your chin pad is more likely to become ptotic with age. It would seem more anatomic to pull the chin pad back up but the stability of keeping it there is suspect when the bone support is not strong. Conversely, the concept of some chin-prejowl augmentation is a more assured result but it does create a bit of a different (new) look for you. So you have to be certain this facial change (slightly stronger chin and jawline) is one you see as better. I personally favor the buildup as it automatically takes care of the chin sagging issue. Either approach incorporates submental liposuction which is a given as an improvement need.
Dr. Barry Eppley
Q: Dr. Eppley, for my chin and jaw angle implant surgery I have couple of questions. I had originally mentioned the idea of some liposuction below the Jaw line/ chin and wanted to see if you thought that was still an option( especially if it could be done through the chin implant incision.) Finally, any ideas of a realistic downtime from work? Would 3 weeks be enough to be off work and able to go back without looking extremely swollen? Also can the surgery be done under IV/ twilight sedation? Thanks again for your time. Thanks again
A: In answer to your questions:
1) Submental liposuction can certainly be done at the same time with access through the same incision as that of the chin implant.
2) The vast majority of the swelling from this type of surgery is from the jaw angles and you are correct to assume that 2 to 3 weeks is enough time for you to look normal, even though the final details of the result will take months to fully emerge.
3) This is not a procedure that is done under sedation anesthesia. Lifting the large masseter muscles off of the mandible is less than a pleasant experience to place the jaw angle implants. This is a procedure that requires general anesthesia to be done correctly.
Dr. Barry Eppley
Q: Dr. Eppley, I am 25 years old and have a chubby face. I am slightly overweight but not as fat as my face makes me look. I am very self concious about my oversized cheeks. I also have a double chin which is very noticeable and unattractive. Do you think a buccal fat pad removal would help me? I have read on the internet that removing it may make your face look too thin down the road. However, I feel that I will always be stuck with a fat face and chubby cheeks as both my parents look the same way. Please advise on what you think would be the best way to help reduce the fatness in my face. Also, are there any less aggressive or non-surgical ways to lessen the fullness of my cheeks and chin? I have attached some pictures of me for your review.
A: In looking at your pictures, I can assure you that nothing short of surgery will help reduce the fullness in your face. I would recommend buccal fat removal, submental/neck liposuction and maybe even a small chin implant. These are some standard techniques in faces such as yours to make a visible difference. While these will not necessarily make your face, they will go a long way to reducing some fullness. It is also important to realize that buccal fat removal does not address all areas of the cheek region in reducing fullness. You will also benefit from liposuction of the perioral mounds and above the nasolabial fold, two areas that are full but lie outside any effects of buccal fat pad removal.
Dr. Barry Eppley
Q: I am 38 years old and I need some changes to my face. It is a very round face without much definition or highlights. From a side view, I think my profile would be much improved with chin augmentation and fat removed from under my chin.. I do not know if my chin augmentation would benefit more from an implant or osteotomy. From a frontal view, I would like the distance between my upper lip and nose shortened. It is too long and I have a thin upper lip as well. I am attaching some picture for you to image to show me what could be done with plastic surgery.
A: Thank you for sending your photos. I have done some computer imaging based on your desired changes. I think you are correct in predicting that chin augmentation (implant not an osteotomy) with submental liposuction would make a nice change. The combination of the two can completely change the profile of your lower face. From a lip standpoint, your upper lip is very long and a subnasal lip lift would help shorten that distance. I have also added a buccal lipectomy to help slim your cheeks which would provide a good thinning complement to the proposed fat reduction in your neck.
The combination of all four of these changes would help make your face more proportioned and balanced.
Dr. Barry Eppley
Q: I am interested in trying to get my face to look less fat. I want to make my face slimmer if possible. I have a small double chin and fatter cheeks and jowls. I have read about Lipodissolve injections and this seems like a good and easy solution for my small areas of facial fat as I know these injections are for small areas and not big ones. Do you think this will work for me?
A: While Lipodissolve injections can provide some minor benefit in fat reduction in the neck and jowl areas, they require three or more injection sessions (spaced 4 to 6 weeks apart) to get the best result. After each injection session, the treated areas will double or triple in size for one week as part of the inflammatory by which it breaks down the fat. . Because of this socially visible recovery, most patients will opt for a more effective set of procedures that actually has less total recovery even though it is surgery. I would recommend a combination of submental, jowl and lateral face liposuction and buccal lipectomies. This reduces all available fat compartments in the face that can easily and safely be treated. This is is the best way to get a slimmer face through fat reduction. It has less recovery than Lipodissolve injections because the swelling is only one time and is largely over after a few weeks.
Dr. Barry Eppley