What can I do to fix lower portion of my face? (Photo)

Question

Weak chin , crooked smile, nasiolabial folds, unrelaxed chin

Kenneth Hughes, MD · Answer

A chin implant could be valuable to improve profile and lower face aesthetics as well as filler or fat grafting to the NLFs and cheeks.

Michael I. Echavez, MD · Answer

You do have some recession of your chin, so you appear to be a good candidate for chin augmentation with an implant.  There also appears to be some flattening in your cheeks.  Injectable fillers could be used to add volume to these areas and this should improve the nasolabial folds.

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

Hi, based on the photos, your face shows signs of mid face deflation, weak chin and lower face skin laxity.  These combine to create an elongated, oval shaped face.   I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants, lip implants), liposuction and/or facelifts for over 30 years.  Many of those facelifts have been the minimally, invasive SMAS facelift.    
 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.  When the cheeks are either concave or flat in the front, cheek augmentation with a dermal filler or using silastic cheek implants (provides a permanent enhancement) can create full, round cheeks that will feminize the entire face.  Liposuction can be performed to reduce excess fat to further shape the cheeks, neck and face.
 There are many faces that have excess fat over the cheek area which hides the "true" shape of the cheeks below.  In addition to obstructing the cheek shape, this excess fat will sag prematurely as it is pulled by gravity at an accelerated rate versus a face without excess fat in the mid face.  Removal of the excess fat, with liposuction, is key when properly shaping the cheeks with cheek implants.  I have used this in combination with cheek implant surgery for 30 years.  In my experience these procedures when combined in a face with excess fat in the mid face are extremely safe, effective and reliable in the aesthetic results they produce.
 I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  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.
 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).   Finally, the skin laxity in the lower face can be addressed.   If you have "jowls” these are sagging facial tissues and the main 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 SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
proper SMAS Imbrication technique
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping 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.
 In contrast, it's important to keep all of the "heavily marketed" non-invasive skin tightening procedures in the proper perspective.  Non-invasive techniques typically shrink the skin several mm's.  There are 25.4mm's in one inch.  The minimally invasive facelift described here can remove 2 to 3 inches of skin which equals 50.8 to 76.4 mm's or up to 25 times the amount of loose skin provided by non invasive techniques.  That reality should always be front and center in the decision making for prospective facelift patients.  It should also be noted that non invasive techniques have no ability to properly dissect, elevate, trim and re-suture the SMAS layer making them one dimensional at best. Hope this helps.

Gerald Wittenberg, MSc, DMD (retired) · Answer

It is important, as you note, to ensure the midface and the jawline are in balance. Your nasolabial fold depth indicates that the 'cheekpads' have descended alongside the nose, which along with the skin consistency, gives a 'depth' to the folds. The slope of your jawline indicates you need be cautious about only a chin procedure or the face will look 'longer' and the labiomental fold will look deeper like the nasolabial folds. Consult the surgeon for a direct review of your underlying bone structure before deciding on a procedure

Michael Elam, MD (retired) · Answer

Dear Abby, You are an excellent candidate for chin augmentation to help balance your profile.  I would also suggest some filler to the cheeks to help balance your overall facial aesthetics. These combined procedures will also help with some of the laxity in the skin. Have imaging performed to show you the proposed results and review the surgeons before and after photographs to ensure expertise. See many examples in the link and video below. Best regards, Michael V. Elam, M.D.

What can I do to fix lower portion of my face? (Photo)

Answers (5)

Answer: Esthetic balance

Answer: Esthetic balance

Answer: Chin Augmentation and Fillers to Cheeks to Improve Facial Aesthetics

Answer: Chin Augmentation and Fillers to Cheeks to Improve Facial Aesthetics

Recommended reading

Everything you need to know about Chin Implant

Our mission is to create a world where every investment in modern beauty is Worth It.

What can I do to fix lower portion of my face? (Photo)

Answers (5)

Answer: Esthetic balance

Answer: Esthetic balance

Answer: Chin Augmentation and Fillers to Cheeks to Improve Facial Aesthetics

Answer: Chin Augmentation and Fillers to Cheeks to Improve Facial Aesthetics

Browse related questions

Recommended reading

Everything you need to know about Chin Implant

Our mission is to create a world where every investment in modern beauty is Worth It.