Do I need chin implant with my lower face and neck lift? (Photos)

Question

I am looking to do lower face and neck lift. I am 49. In need of lower face and neck lift ? Do I need a chin implant to balance my face? How about fat transfer? Who is the best doctor on east coast for this procedure?

Jason Emer, MD · Answer

You need a formal evaluation with a facial sculpting expert and plastic surgeon to discuss your aesthetic goals and determine the best treatment plan for you. Many of my patients try to avoid surgery, so we perform a non-surgical chin augmentation treatment with injectable fillers. Fillers like Radiesse as well as Sculptra are injected into the area, improving the overall appearance of the lower face and balancing the jaw and lip harmony. We use cannula injections to meticulously contour and project the chin, soften the chin along the jawline and improve the chin crease. Fat grafting can assist with volume improvement in the area as well.Surgical implants are a great option once you are 100% positive that you are ready for a permanent enhancement. See an expert. Best, Dr. Emer

Richard G. Schwartz, MD · Answer

Adding chin projection with an implant creates facial balance and harmony for anyone with a recessive (small) chin, as your photos show.  This would create a more ideal facial appearance.  Your photos also show lower jowl formation just above and at the jawline and minor looseness/fullness under the chin.  You are a good candidate for a lower face and necklift, and the chin implant can be easily placed through the same incision that is used to remove fat under the chin and tighten muscles on the front of your neck.  However, some patients are not bothered by a small chin, so it really depends on the type of change you are hoping to achieve.

Ali Riza Öreroglu, MD · Answer

Based on your photos, it appears that you could benefit from a slight augmentation of the chin. This can possibly be provided quite nicely with fat grafting. Best to consult a board certified facial plastic surgeon in person and discuss your options after a physical examination.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Dilip D. Madnani, MD, FACS · Answer

hi, thank you for the pictures. It appears you will do well with both a lower facial rejuvenation and facial fat transfer. As for the chin implant, that would be better determined in person, as once we can see what you look like with the lower facial laxity improved, we can have a discussion as to what your idea is for the chin implant. More projection may not be a great idea for you as you do have nice fullness in your chin already.

Nirmal Nathan, MD · Answer

Dear Butterfly11,Thank you for your great question! Chin implants are sometimes used when indicated to provide additional definition during a necklift. Photos alone are not a good way to assess but you have other options as well, such as long lasting filler injections to the chin. A reputable and experienced surgeon should be able to determine what option is best for you during consultation.Best regards,Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgeons

Gregory Lakin, MD · Answer

Thanks for your question and photos. Facelift, facial fat grafting, and chin augmentation are all good options for you. I recommend you consult with a board certified plastic surgeon with experience with these procedures to discuss your goals, examine you, and show before/after photos to give you a better idea of the type of results you will get. Good luck!

Manuel M. Peña, MD · Answer

Great question! Just a quick note about possibly using fat grafts to add that little bit that would make your jaw line and profile a bit crisper. You may not need much increase in projection to achieve an outstanding result. It would be helpful if you consulted with a Board Certified Plastic Surgeon that used a 3D imaging system. This will let you see the advantages of different options before you proceed.

Francis R. Palmer, III, MD (retired) · Answer

Hi, yes it appears that you do.  I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  From the photos, the cheeks are a bit flat in the front with evidence of "mid-cheek grooves" (indicating a lack of underlying bony volume), jowls are present, the chin is weak as are the back portion of the ja wine.  These combine to create an elongated, rectangularly-shaped face. The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection less bruising and swelling rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
proper SMAS Imbrication technique
no incisions within the hair no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.

Melih Erogul, MD (retired) · Answer

Hi and welcome to our forum!
From your photos, your chin is slightly retrusive. We also need to know your dental occlusion. If normal, you would be considered a candidate for chin augmentation, which is usually accomplished with a small solid silicone rubber implant. This can easily be added to the facelift and neck lift procedure. 
As it is a very common procedure, most plastic surgeons offer this surgery.
Best wishes...

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