Personally, I think my face is a little bit older than my peers because my cheek is big ,and I have a lack of mandibular angle which makes utterly my face look hevier in lower third of my face. Perhaps I am asian, particularly South East Asian ( I share some traits with my ethnicity). I’m a 18-year-old boy but I look my face as a mid 30 person. Should I need a procedure to enhance my facial length or anything else to make my face as young as my real age
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Screws prevent migration of the implant, which can cause other issues. However, a custom implant works best to avoid shifting and, just as importantly, aesthetic issues. More than health-related concerns, subpar aesthetic results with off-the-shelf implants are more common than any other issue.
I’m guessing the issues have to do with your mandible. If you have not done so already I suggest you have an oral surgery consultation or preferably a few of them.
It may be the body of the Mandible or the chin/mentalis. I see no indication for having your teeth pulled out.
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It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.