What Lower Facial Reshaping Procedures Do I Need?

Q: Dr. Eppley, I was wondering if you would have time to pop a quick email response back to me with some advice and quotes. I have a heavy lower 3rd of my face. I have seen a variety of ways to address this (jaw reduction, buccal fat removal, perioral mound lipo, facelift) and I’m wondering what he would recommend. My goal is to have cheeks that are round and full in the front and a vline, slimmer jaw shape that is not so bottom heavy and long. When I lift the tissue around my jaw towards my cheeks/ears it helps me get more of the look I desire. I will attach some photos! Thank you. 

A: Thank you for your inquiry, sending your pictures and detailing your facial concerns/objectives. Your facial reshaping question is a common one to which I can make the following comments:

1) While pushing/pulling the tissues back along your jawline in front of the ear creates the desired lower facial reshaping change, that does not mean that a lower facelift will end up with the same result in a young person without significant tissue laxity. In other words, the ‘facelift’ maneuver over estimates the effect it can create and sustain. And this should not in a young person be the go to first procedure for lower facial slimming. That doesn’t mean it should never be done but it should be either the procedure of last resort or a complementary procedure to others being done

2) For you the procedures of bony jaw angle reduction (width only), masseter muscle reduction and perioral/lower facial liposuction would be the foundational procedures.

3) You have good cheekbone structure but to enhance that further buccal lipectomies with anterior cheek augmentation using either the buccal fat as pedicled transfers or converted to fat injections or a small malar shell implant would be the approaches to achieve cheeks that are rounder and fuller.

Dr. Barry Eppley

Indianapolis Indiana