What procedure would you recommend? Help! (Photo)

Hi thank you for the question ,
This is an interesting question . As we age we develop structural laxity in the face whether it be in the skin or deeper structures in the face. As we develop laxity tissues move south and lead to some of the early signs of ageing like hollowness in the midface with separation of the lower eyelid fat from the midface and also deep folds around the mouth called nasolabial folds and jowling which leads to squaring of the face. Laxity also develops in the neck. These seem to be the key difference in the photos you have provided versus what you describe as a desired look. Facelifting which addresses structural laxity can be effective at addressing these changes to give a natural result and affect, as you say the lower face and jaw line mainly.
Morpheus which involves microneedling and radiofrequency affects mainly the skin and is less good at addressing overall structural laxity in the face.
As we age we also lose volume and so in addition to repositioning tissues restoring volume is useful and fat grafting which is your body's own natural filler can be good for this and has the added advantage of improving skin quality . Implants may have a role too if say your chin is not prominent enough for the overall proportions of the face but this is difficult to assess from photos.
I dont know your age but you do seem to have some early signs of structural laxity in the face.
I hope this information helps guide your decisions.

Looking at your photos, it seems your jawline definition is very good and there does not appear to be prominent jowls. A Non-Surgical Treatment route could be beneficial for you, skin-tightening treatments like Morpheus and Potenza RF Microneedling can help. Even a treatment called Thermage JawSculpt, which is what we offer at 111 Harley St. could be be suitable for you too, which is a combination of Botox and Thermage to both slim and tighten the face.

If you're interested in a Lower Facelift, this too can help to sculpt the face and re-establish your face's natural contours so it depends how much of a dramatic result you wish to achieve. A more dramatic would equal a surgical procedure rather than non-surgical treatment.

Micrografting is like a surgical alternative to filler, so this involves you natural, ultra-pure fat injected into the area lacking in volume – so this takes the form as a liquid whereas with a Chin Implant, the implant is made of silicone. So, depending on where you wish to achieve definition, one would be more suitable than the other. For you, I would not recommend this as you have already had Buccal Fat Removal so adding volume to this area would be counter-productive.

If you are very unhappy with your appearance, book a consultation with a reputable surgeon or Practitioner who will be able to discuss options for you.

Unfortunately, it is difficult to answer your questions without having a formal discussion with you of your specific surgical goals and a formal physical exam. Let me help answer some of your questions and give you more information though..1. Morpheus treatment primarily helps with skin tightening in a noninvasive manner. A facelift or mini-facelift similarly help with skin tightening (by surgical removal of excess skin), but also allow for adjustments to some of the deeper face structures- e.g. tightening of the SMAS layer, simultaneous fat grafting to certain areas to fill deficits. Also, if you have prominent jowling, significant neck skin laxity, or banding in your neck, these are best addressed with some type of facelift instead of a noninvasive treatment like Morpheus.2. Fat grafting adds volume to specific areas of your face by taking the fat from your abdomen or thighs, and injecting it into your face. This is your body's own natural tissue, so you don't have to worry about rejection or reactions to the injected material. Once the fat "takes" (lives and integrates into the new injected site), the results last a long time. Implants, however, are artificial materials which are placed under the face skin in a variety of ways and locations to add volume to those areas. Medpor and silicone are popular options- Medpor is my preferred implant, especially with chin implants- this material integrates well to the surrounding tissue, and has less chance if migration or distortion. For cheeks, my preference is fat grafting instead of implant placement. If you were getting cheek fat grafting anyway, it would make sense to get fat grafting to the chin at the same time, instead of cheek fat grafting and chin implant..With all that said, the angles and harsh lighting in the photos provided make them only somewhat useful to help illustrate what you are describing. I would urge you to arrange a formal consultation with one or multiple plastic surgeons to really discuss your surgical goals, be formally examined, discuss all your options, and decide on the best procedure(s) for your specific case. I hope this helps!.Best, Dr. Donald Groves Plastic Surgeon