Ask a doctor

Procedures to Improve Bottom Heavy Face?

I would like to have surgery to improve my jawline but I'm confused about my options. I assume I will need Liposuction, but what about the neck bands and the front profile?

Would it be a Neck lift, lower Face Lift, short scar facelift? I am not quite 40 yet, but close. No Chin implants please. I know my profile shot shows a weak chin, but when I smile my chin comes out to play, and I am quite happy with it.

Doctor Answers 18

I might be crazy but...

keeping in my mind the photos tell only a portion of the story I will address what I see only.

based on your neck, skin quality and jawline a facelift would be just too much.  I dare say you look younger than your age. I know you want to look better not younger but remember 10-20 years from now your goals will be to look yonger. ironically overtreating the fat in the lower third of your face may leave you unhappy in the future.  I just answered a question from a pt who had neck irregularities after liposuction of the neck.  I think the fat you have is possibly too deep for lipo and that procedure may leave you with banding and fullness. there are two new things you might want to look into: 1. zerona- releases fat without killing fat cells so theoretically irregularities are not possible and it does not require surgery, injections or any recovery, 2. Iguide neck lift to support muscle layer with minimal downtime. I recently started to consider these options for my pts just like you. hope this helps.

p.s. I hate chin implants. I agree with your asessment.


Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Procedures to improve bottom heavy face

The archetecture of the face and neck must be considered as a whole to evaluate balence, equilibrium and harmony. Your pictures only show half the story, but from what I see I feel 2 treatment options could be pleasing.

1. Suction of the neck and jaw line to remove your submental fat pocket and define your neck/face junction. I do not see neck (platysmal) bands in your photos.

2. A short scar face lift with neck liposuction

Barry H. Dolich, MD
Bronx Plastic Surgeon
4.0 out of 5 stars 1 review

Bottom- Heavy Faces

Thank you for your question.

Possible procedures include:
  • Suction of the neck and jaw line to remove your submental fat pocket and define your neck/face junction
  • A short scar face lift with neck liposuction

Ramtin Kassir, MD
Wayne Facial Plastic Surgeon
4.5 out of 5 stars 56 reviews

Liposuction could be the answer...

Although your pictures are helpful, it’s hard to make a recommendation without performing a physical examination. Your pictures suggest submental fat deposition with surprisingly minimal skin laxity. Some of your lateral pictures suggest redundant skin but your head appears to be turned to the side. Under these circumstances, skin folds would be expected.
Based on these findings a facelift probably isn’t indicated under these circumstances, treatment of submental fat with conservative liposuction would result in excellent contour improvement.
If you’re considering treatment of this problem, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to perform an examination and make an appropriate recommendation.

Facelift for bottom heavy face

The basis of a facelift is not pulling the skin rather it is repositioning of tissues under the skin and then re-draping the skin over the more youthful understructure. In some patients neck liposuction, fat grafting and other procedures to the eyes or forehead are done concurrently.

Lower face and neck options

from what I can see, Liposuction would give you a good degree of improvement, and if a small platysmal band is palpable, the submental incision could be extended and those sutured together. I do not think you have enough skin laxity in the neck at the present time to warrant the neck lift scars.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 11 reviews

A chin implant would be placed against the bone of your jaw so that it feels like an extension of your natural jawline

While you are not fond of the idea of the chin implant, that may still be the best choice.  A chin implant would be placed against the bone of your jaw so that it feels like an extension of your natural jawline.  Not only would this improve your jawline and front profile, but it would also improve your side profile and the contours of your neck.  I believe that a facelift or neck lift are more aggressive approaches than you need at this point.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 14 reviews

Improving "Bottom Heavy" Face

Liposuction would be helpful as part of a facelift or necklift, not as an isolated procedure. I would recommend a facelift if you do not want a chin or chin-jowel implant; otherwise a necklift with chin implant should be considered.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Improving a bottom heavy face

According to the picture shown, there is no evidence of needing a face/neck lift or neck bands. It is impossible to narrow the lower third of the face. Liposuction is not a good idea since there is no fat in that area of that chin. In the neck structure itself, the primary goal of a neck lift is to remove excess fat above and below the platysma muscle to sharply delineate the jawline and tighten the neck muscles.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Improving bottom heavy face

Judging from your pictures, you have a youthful face/neck contour at age 39. There is a small of fullness of your neck under your chin and this could be judiciously and conservatively liposuctioned. Your pictures do not demonstrate

neck bands

or significant excess skin. Therefore, at your age and with your demonstrative findings, I do not think that a

neck lift

or lower

facelift

is necessary at this time.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.