What can I do to fix my weak jawline and chin? I don’t want to do surgery. (Photos)

Question

I don’t think I used to have this issue but I also used to be very underweight. I gained (much needed) 40 lbs, and am 5’6” at 130 pounds currently. Could my chin and neck looking less defined be due to this? Although, I am currently average weight and still look skinny. It’s just my face that’s terrible!! What can I do?

Ariel N. Rad, MD, PhD, FACS · Answer

Hi! You're ahead of the game because you have beautiful facial features to start with. Looking closely you have some asymmetry in your lower face and jaw region: your left side is not as well defined. You have several excellent non-surgical approaches available to give you better jawline definition and symmetry:  (1) fillers such as Voluma (cross-linked HA) or Radiesse can be used to sculpt and define your jawline - I would add relatively more volume to your left side to improve symmetry; (2) fat reduction under the chin: I would recommend liposuction in the office under local anesthesia (awake but numb) - this is predictable and effective to remove fatty tissue. Even though this is a surgical procedure the incision is tiny, and it doesn't have the risk that Kybella has. I would shy away from Kybella because of the risk of nerve injury; (3) Skin tightening with Thermage FLX. This is the newest radiofrequency device on the market and very few practices have it. It is a "smart" RF machine in that it detects skin temperature and so can titrate the energy to ensure that you're in the "skin tightening zone."  This is much more advanced than current devices on the market which don't sense temperature and therefore can't tell whether your skin will tighten or not. (4) Chin augmentation with filler or an implant can define your lower face even more - I recommend a small implant for permanent improvement. (5) Buccal fat pad removal - even though this is technically a surgery it can be done with completely invisible incisions (on the inside of the mouth) and in the office under local anesthetic (awake). By removing the "chubby cheek" fat the jawline and lower face becomes more defined and "chiseled."Good luck!

Randal Haworth, MD, FACS · Answer

There are a variety of techniques that can be used to improve your profile and to give the appearance of a more defined jawline. A more temporary approach includes dermal fillers (e.g., Sculptra, Voluma, and Radiesse), while fat grafting, use of permanent fillers (Aquamid, Bellafill ) and facial implants would offer a more permanent solution. To address your concerns I would recommend having an in person consult with a board certified plastic surgeon who specializes in facial aesthetics.

Jonathan Kulbersh, MD · Answer

You have a few options to achieve a stronger-looking chin and profile. If you’re not sure you’re ready for surgery, but still want to improve and strengthen your chin and profile, I’d suggest augmenting your chin with Sculptra and/or Voluma. I’d also remove the fat underneath your chin with liposuction or Kybella. If you like your new look, you can make it permanent with a chin implant.

Zoran Potparic, MD · Answer

It is very hard to give you good advice based on these photos. In-person evaluation would help. However, I would consider mild augmentation/shaping of chin and jaw line with fillers, or better with fat grafts. A small sculpting of neck may be considered? Good luck.

Kapil Saigal, MD, FACS · Answer

First of all you look great! Not everyone is ready for or needs surgery to enhance their features. Fortunately there are a lot of options for this situation! If you would like a non-surgical treatment to augment your chin and give some jawline definition, I would consider a filler such as Voluma or Radiesse to the chin, and consider Kybella to the submental (anterior neck) fat treatment to improve the balance bw the chin and the neck.
Best of luck to you!

William Portuese, MD · Answer

The fatty deposits in the neck can be removed with liposuction which  will improve the jawline. Placement of chin implant allow for better facial balance  and proportions. For many examples of both procedures, please see the link and the video below

Darryl J. Blinski, MD · Answer

Might be a great candidate for the Y Lift (Liquid Face/Neck Lift). I would use up to 20 syringes of HA fillers placed on the facial bones to elevate and rejuvenate your appearances. Lasts 2 to 3 years. Fees in the $8,000 ranges. Only 2 certified Y Lift providers in Florida, BTW.

Kailash Narasimhan, MD · Answer

To treat the chin and neck, there are several non-surgical options. Kybella, which has been heavily marketed, is a relatively new treatment to help dissolve fat around the chin and neck area. This involves injections in the office without having to undergo surgery.  There is some swelling involved and redness but most Patients who are good candidates have great results.  Traditional liposuction would involve a small incision but could also remove the fat.  If you have a good skin tone this might be a great option. Only an in person consult would allow us to determine the best option for you. good luck!
Sincerely 
Kailash Narasimhan, MD
Tampa Bay Plastic Surgeon
Board certified ENT and Plastic Surgery

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

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin, lips), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front, there is some excess fat in the lower face and under the chin, the chin is weak with some excess skin under the chin as well.  These combine to create an elongated, rectangularly shaped face.  
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Since you aren't interested in surgery, dermal filler seems the best option.  Do not use fat to shape your face (discussed below).
 I have performed many Chin Augmentations using chin implants for over 30 years.  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  However, since you aren't interested in surgery, once again a dermal filler seems to be a logical choice to augment your chin.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).  I have performed many facial shaping procedures using dermal fillers, facial silastic implants, liposuction and facelifts for over 30 years.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

What can I do to fix my weak jawline and chin? I don’t want to do surgery. (Photos)

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