Slouchy facial profile - what are my options? (Photo)

Question

I have always been less than flattered with the lower half of my face. It’s very droopy and wide. My chin is a bit long and I feel like I have a slight overbite. I would like a more define and flattering side and frontal profile. Not sure what my options are. Please help.

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy  is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy  is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Tanveer Janjua, MD · Answer

Kybella injections can give some improvement but better contouring and profile from Chin Liposuction and Thermitight
Chin liposuction helps reduce the bulge under the chin and can be done for the whole neck. Once the fat is removed the skin can become loose and saggy in some cases. It can be avoided by combining it with Thermitight which is a radiofrequency heat delivered under the skin to tighten it. Both chin liposuction and Thermitight can be done at the same time. The recovery is fast and it can be done under local anesthesia.
Click on the video link below
Regards
Dr. J

Mats Hagstrom, MD (license on probation) · Answer

Primary facial aesthetics are determined by facial bone structure.
Soft tissue coverage tends to be much more consistent from person to person.
it is the facial skeletal structure that gives each unique person their own appearance, whether desirable or not so much.
The ability to recognize each person as an individual is in the end, mostly determined by their bone structure.
It is the facial, skeletal structure that computers recognize when doing identification. 
Soft tissues have a lot to do with facial aging but much less with primary facial aesthetics.
Issues related to the lower 1/3 of the face are therefore generally related to the shape and size of the mandible, especially in relationship to the maxilla(the skeletal mid-face) .
Changing the shape or size of the mandible is not easy or straightforward at all.
This causes providers and patients alike to look for soft tissue alternatives.
The problem of applying soft tissue solutions to problems that are based on skeletal structure is that the treatment does not aim at fixing the primary problem. soft tissue solutions to correct skeletal structure problems are going to give a partial improvement at best and sometimes it doesn’t even do that.
if the mandible is short or lacking in projection, individuals often will have an overbite dental occlusion, this also can lead to early loss of jawline definition, formation of a double chin, and early development of jowls. It’s also important to understand the shape of the mandible, or which anatomic region of that bone has a potential problem.
Someone can have a mandible that lacks in projection in the body of the mandible, but at the same time has a mentalis or chin region that has strong projection.
This is one of the most complex Anatomic combinations to assess and treat.
In your case, the vertical height of your chin is good. The chin has slight projection(it does not slope backwards). The main issue is the projection in the body of the mandible not so much in the chin. This explains the overbite occlusion.
Advancing the chin or mentalis region of the mandible would probably be helpful. Doing so is much easier than advancing the mandible further back(jaw advancement) excessive chin projection will cause deepening of the labiomental sulcus. If over done it can begin to look masculine. A strong mandible gives a look of confidence. 
To see the impact of having a larger well developed mandible take a look at George Clooney or Carmen DelOrafice. 
In my opinion oral surgeons have an upper edge over plastic surgeons for both assessing and treating issues related to the mandible. Some plastic surgeons may have advanced knowledge and training in this type of work as well. Both specialties contribute to this type of work, 
I suggest having a few in person consultations with both oral surgeons and plastic surgeons in your community.
The picture you posted is good.
Get a complete set of facial pictures and bring those with you to the consultation.
Always have pictures of yourself to use as reference during consultations, especially when reviewing before and after pictures.
Don’t rely on memory or looking in the mirror.
Both assessment and treatments are fairly complex for this kind of work so expect different providers to possibly have different opinions on how to approach treatment including what the underlying ideology is.
Having a quality assessment leaving you with a thorough understanding of your facial skeletal anatomy and all treatment options is a good place to start regardless of what treatment you may end up choosing. 
This is why I recommend getting a formal assessment by an experienced craniofacial surgeon first. Even if you opt for injection of fillers at a local med-spa by a nurse. 
Best,
Mats Hagström MD

Slouchy facial profile - what are my options? (Photo)

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Slouchy facial profile - what are my options? (Photo)

Answers (3)

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