Would I benefit from buccal fat removal and / or V-Line surgery? (photo)

Thank you for your question. Buccal fat removal could be an option for you, as this would remove the additional fullness from the midface to create a more sculpted appearance. You might also benefit from dermal filler injections to add sculpting to the jawline to create the V-shape you want. I recommend scheduling a consultation with a board-certified facial plastic surgeon who has extensive experience in facial contouring. Through a thorough examination and discussion of your concerns and expectations, your surgeon should be able to tailor a treatment plan to serve your precise needs and goals. 

Buccal fat removal and v-line surgery produce very different results and are not done for the same purposes. Given that you have had Botox injections and feel that your lower face is bottom heavy, it is more likely that jawline contouring is more appropriate than buccal lipectomies. Buccal lipectomies have no effect on the lower third of the face or the jawline. Computer imaging will help you better understand what these procedure can and can not do.

From the photos that you have provided, it appears that you have a moderate amount of soft tissue in the cheeks / jowl area, and a defined mandibular boarder and angle. Without the benefit of a thorough physical exam, your pictures suggest that bone contouring may provide you with the results you desire. Some surgeons may request a CT scan of your face to determine the optimal amount of bone to contour. More projection with your chin could also contribute to the narrow jaw you are looking for. 

It does appear that you are an excellent candidate for buccal at remioval. The pictures also show a pre-jowl depression that would make your cheeks look bigger. How is your chin projection and definition? These are some ideas to discuss at the time of consultation.