Based on what you describe as well as your pictures, you know you have two issues going on at the same time.One is the structure of your mandible or your lack of jaw projection. The second is potential fat in your chin and neck area. If I was to pick which of the two issues was most important, I would say 80% of your concern is related to your bony facial structure, and 20% is related to fat.If you want the best look possible, you may need a chin implant or sliding genioplasty with liposuction.There are some other procedures that can be done to tighten the neck, such as sewing the platysma muscles together in the midline.This can also add tightness and definition to the neck and can be done at the same time as placing a chin implant and/or liposuction. Liposuction by itself will not yield an impressive result, in my opinion. As plastic surgeons, we are taught to learn emotional reactions from facial expressions and imperfections. For example, bags under the eyes show age and also give off a look of tiredness. Front lines give off a look of anger even when the rest of the face is smiling. Crow's feet show age, sun damage but also give a sense of warmth because they are associated with smiling. Strong foreheads can give a sense of power. Strong cheekbones portray a sense of confidence. An undersized mandible or weak chin projection gives the look of less confidence or meekness. A double chin gives an impression of obesity while jowls give the appearance of age.The above stated descriptions are my personal beliefs and may differ from others' thoughts and opinions. The way I analyze your pictures is that adding chin projection and removing the fat will give your face a sense of confidence. Removing some of the fat will give a look of being thin and athletic.Your pictures show someone with excellent facial features, great cheek bone projection, nice and high arched brows, etc. The enhancements described would give your pretty face an enhanced sense of balance. If you're considering a chin augmentation please keep the following in mind: avoid an aggressive, large implant. I don't think you should have anything but a small correction. It's possible to make a chin implant using temporary fillers. This may be an excellent way for you to take a test run to see how you would like your own appearance with more chin definition. As a general concept in facial aesthetics surgery, improving several small deficits can give a striking improvement without changing how someone looks. This is in contrast to having one major correction, which can make someone look a little bit like a different person.Lastly, an alternative to chin augmentation using silicone implants is a sliding genioplasty. This technique is often favored by oral surgeons as well as plastic surgeons who have done training in craniofacial surgery. The advantage to this procedure is not needing an implant. Placing silicone implants can have some adverse consequences.Best of luck,Mats Hagstrom, M.D.
