34 year old female, not overweight- jowls and chin issues. Any suggestions? (photos)

It would be difficult to answer you question precisely without having a chance to touch your face and to move the tissues around. However, you do have an over-projected nose that is deviated to your left with asymmetric nose bones, asymmetric tip with concave cartilage above the right side of the tip, higher right nostril and dorsal hump. Your chin is slightly underprojected which appears worse because of the over-projected nose. Augmentation of the chin needs to be done very conservatively, if at all, to avoid deepening of the groove between your chin and your lip and making your face too long.You could benefit from repositioning of volume in the jowl area upwards using some type of lifting. This migration of the tissue downwards is creating slight hollowing under the eyes and cheek area. Those of us who specialize in the face rejuvenation and rhinoplasty have multiple lifting techniques that we offer depending the patient's age, skin condition etc which ranges from very limited lift to a full face lift. Adding small amount your own fat on the chin and each side of the chin could be the simplest and most effective way to blend your chin with the rest of the face. It will reduce the pointy appearance and take away slight goofing on each side of the chin You seem to have minimal excess fat under the chin removal which may make your chin more defined without adding the to chin. Please avoid letting anyone to augment your chin too much. This will have adverse effect on your face.

You are an optimal candidate for the so called profileplasty, which
consists in doing rhinoplasty and chin surgery at a time, a safe and
routinary procedure in experienced hands.Your nose needs basic
complete rhinoplasty via closed approach to shave down the high dorsum, reduce
the tip projection and narrow frontally and perform osteotomies. Let me notice you also suffer right side (only) inverted / concave lower lateral crura, creating a dip on that hollow alar cartilage; if you want this fixed then we should turn to open approach and likely evert the faulty part or replace it by a hand-made custom cartilage graft. Your chin needs
anterior advancement and for this I recommend sliding genioplasty,
eventually with vertical height increase by means of bone grafting. Great part of your jowls is a mere apparent problem, caused by the lack of tension of the underlying skeleton, so you can expect improvement there. Do NOT accept any fillers or bucal fat pad removal, at all.Being an option, chin implants have serious disadvantages, specially in
the mid and long term, patients are rarely happy with them after 5-6
years, all are out by then or later.Consider the chin advancement by means of sliding genioplasty, the advantages are:-lifetime procedure, no more revision or renewal procedures-more natural than implants-no visibility of implant edges during gestures-improves
the double chin effect at the sub-mental muscles (floor of mouth)
hammock caused by lack of tension there; also improves the shape and
tension of perioral muscles; implants do no offer this feature-horse-shoe enhancement, covering the chin and also the jaw sides of it-no future displacements or neuritis of mental nerves-practically zero infections and 100% healing of bones-no
need for complex plates and screws that may need future removal; just
steel wires synthesis may suffice, they stay buried into bone callusThe cons are:-expensive, but cheap if you consider the lifetime pros-technically
demanding, few surgeons are experienced or comfortable (though I
personally perform 100% of the chin augmentations by this osseous
method, always after offering the patients both options)-scary for the patient (though not so much if you explain well the stuff around it)You'll
find in this website dozens of negative experiences with chin implants
in the short and mid term, do read my profile's Q&A and you'll find
them too. I am doing sliding genioplaties for 15 years with the highest
success and no one patient regreted, totall the opposite, I did many
chin implant removals and one staged sliding genioplasties to replace
them.

 Thank you for your pictures. Here are my observations.You have a deep mental crease which leads me to believe that you have possibly a recessed lower jaw and/or a small chin.You have a short vertical lower third of your face The jowling that you have is due to observations #1 & 2. In my opinion you need an evaluation of your occlusion and lower jaw all for possible bilateral sagittal-split ramus  osteotomy to move your jaw and chin downward and forward. Best wishes

Based on your photos a combination of procedures should be considered. Your pointed chin doesn't need augmentation in particular considering your pending rhinoplasty which will improve your chin/nose balance. However, placement of chin implant which will widen your chin and fill depressions on the side of the chin in front of jowls will help (Mittelman pre jowl implant). Conservative liposuction of jowls should be  part of this procedure.You should discuss these options with your plastic surgeon before your scheduled septorhinoplasty surgery since these procedures can be done in the same time. Good luck.

 The photographs demonstrate an overly projecting nose, and  an under projecting chin. Consider placement of a chin implant to bring the mandible forward to help with facial balance and proportions, especially with respect to the overly projecting nose. Chin implants are manufactured in a large variety of sizes and shapes, and are usually placed through an incision underneath the chin. A chin implant is very complimentary to a rhinoplasty procedure which will decrease the projection of the nose. Simple liposuction in the neck can also remove the fatty deposits in that location. For more information and many examples of this combination, please see the link and the video below

Thanks for your question and congratulations on your upcoming septorhinoplasty surgery. You raise an important issue regarding facial balance in both the front and side view images. It appears that you lack some projection in the central chin area, and also may have some lateral contour problems of the geniomandibular groove (between the chin and the jowl area). Fortunately, your facial harmony can be rejuvenated with a silastic, geniomandibular chin implant, especially designed for this problem. Implantech, Inc makes these styles of implants. I believe that this type of implant could compliment your rhinoplasty and offer you significant benefit. Hope this answer helps. 

  Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties.  From the photos your cheeks are flat anteriorly (in the front), there is excess fat in the lower face, jowls are present, the chin is weak and the nasal tip is over-projected (sticks too far off the face).  These factors combine to create a rectangular shaped face.   Following the beauty principles outlined in my book on face and body beauty, 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.  I would combine liposuction to reduce excess fat in the lower face for further facial shaping.  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 and highly effective.  "Jowls" are sagging facial tissues and an 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 facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine whatever facial shaping that's necessary 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.  Till pasty, without a full Rhinoplasty can thin, refine and reduce the projection of the nasal tip.Hope this helps.