What are my options in getting a sharp well defined jaw line? (Photos)

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

In the submental region, there are three basic main causes that can be treated (and lots of additional smaller causes that can't): fat, looseness of the underlying muscle (platysma), and extra skin.

While liposuction will reduce the fat below the chin, unquestionably a better solution would be weight loss.

In your case, the platysma muscle is also likely involved, and there is also subplatysmal fat at fault as well, and possibly a low-positioned hyoid bone (not much you can do about the underlying anatomy). Tightening the platysma muscle and possibly defatting the subplatysmal area can great enhance the cervicomental angle in many patients. Subplatysmal dissection is tricky because of risk of damage to the marginal mandibular nerve in particular, not to mention a few pretty large blood vessels as well.

While minimally invasive tightening devices make great promises- and we do use them in my practice when appropriate- they just don't tighten the skin that much. If you are expecting surgery results, you will likely be disappointed with the minimally invasive techniques. The reason for this is that when the skin is heated too much, by any technique, the subdermal blood supply becomes damaged, circulation is affected and skin can change color, become stiff (like radiation) and even become necrotic. I have seen many such cases, especially with laser liposuction or aggressive radiofrequency tightening.

If significant skin excess is present, most patients are best off with a lower facelift or facelift. I have a busy facelift practice, and almost everybody I see now has tried Kybella, Ultherapy, FaceTite, submental liposuction alone, etc. etc. etc. only to need a facelift in the end anyway. And many of these techniques excessively defat the neck while not significantly tightening the skin, causing a premature aged appearance.

So before you spend your hard earned money, make sure you're getting the right procedure by selecting a surgeon who can do and frequently does both minimally invasive and surgical procedures.

Hi Bob,

From your photos it appears that liposuction of your neck is the ticket. You may also benefit from Sculptra injections along your jawline. Good luck and be well.

Dr. Persky