Benjamin Caughlin, MD, FACS

You know it really is about having structure. When people come in we do a facial analysis to line up the metrics of the face to see what you can tolerate in order to get your jawline as sharp as possible. In you it appears to be all about the cervicomental angle and adding a bit of height to the chin. Find an experienced surgeon you trust and be clear with your goals. Best, DrC

Buccal fat does not cause one to look old. The key is to first define what old is and what hot is. The people that say buccal fat pad ages you like a round circular face. I particularly think the contours achieved with buccal fat get better and more hot with age. Contour itself does not equal aged. Think Angelina Jolie. She gets more attractive as you see more contour in my opinion. The buccal fat pad is a deposit deep fat pad. There is good literature it gets LARGER as people age. In some it leads to a bull dog look. So it is the superficial fat pads that shrink and lead to aging. That is the fat you want to preserve. That is the layer fat is transferred to. It is important to note that as the superficial fat pads shrink the buccal fat pad contour will become more noticeable. Many think that is a nice look. That is what needs to be discussed. It's a complicated process but if you want a contoured lower 1/3rd then the buccal might still be the right thing you just have to realize that as you age you will see more of that contour. google deposit fat pad for example and do some research on that topic. Hope this is helpful. Find a surgeon you trust and be clear with your goals. Best of luck, DrC

This is very good insight. You know the fact that at any weight you still have a "double chin" or lack of jawline really helps us determine likely there is some structure deficiency that leads to your "problem". I would say some sort of chin augmentation along with what I call jawline sculpting lipo including posterior to the SCM is what would give the best results. Find a surgeon you trust and be clear with your goals, Best, DrC

Buccal fat does not get this area. In my experience key is to build structure around this to balance it. I have done microfacial lipo in the area but typically this is only after fat transfer or bad filler. Often times making the zygoma more prominent or the chin even can help. If you put a finger on the chin and a finger on the lateral cheek and separate them that is what this can mimic.

Those are all options of course. In my hands, from looking at your photos, projecting into the skin with a bit of filler and/or microfocused jawline sculpting with a lipocannula would be the homerun! Find a surgeon you trust and be clear with your goals. Best, DrC

Listen, there are certain anatomies that just cannot get overly sculpted and hallowed. Asian is one of them. Google deposit fat pad. The buccal fat is a deposit fat pad and gets bigger with age. It gets bigger with age. Leads to a bull dog look. In combo with chin lipo it can really saddle the mandible.

It's all about volume in the right places. You mentioned it in your question but often times when people say it is a "family trait" they either have a soft chin or a low hyoid bone. The hyoid bone is a bit more difficult to manipulate but the chin is relatively easy to change. I do at least 3 chin implants a week. It's a niche of mine. When I do a chin implant I always do extended neck liposuction because I am right there. No doubt. Find a surgeon you trust and be clear with your goals. Best of luck, DrC

I get asked this question often. The key here is buccal fat pad sculpting leads to a contoured look of the lower 1/3rd of the face. If that is something you like. If that is an aesthetic you are after then it is possible we can use this procedure along with tightening of the buccal mucosa and buccinator muscle (with DrC only!) to help contour and maintain a tight lower 1/3rd of the face. Find a surgeon you trust and be clear with your goals. Best of luck, DrC

At this point 95% of my cases are done under local (awake). We give a few oral meds to take the edge off. Think two margaritas. The face has very predictable locations for sensory nerves. We are able to completely number them for a few hours with minimal amounts of anesthesia.

From your photos I would say you have great chin and look relatively young. People with those attributes do great with neck and jawline sculpting. It is like an extended neck liposuction to allow the neck skin to shrink wrap the mandible better. Along with some buccal fat and it's a cherry on top! Of course kybella, fillers and other devices are possible to help sculpt but from a results perspective I think the above would be best, in my hands at least. Hope this is helpful. Find Surgeon you trust and be clear with your goals. Best. DrC