My neck & chin seem connected & there is no definition to my jawline - what's wrong? (Photos)

Question

I’m a 23 year old female and my side profile has always been ugly. I have had meso fat injections numerous times and chin filler 5 months ago . I’ve also had massater Botox. Under my chin still seems to hook up to my neck like a turkey and I get called fat but I’m not fat. Will try to include pics. I do face yoga and try to work out but nothing helps.

Daniel Barrett, MD · Answer

Dear Intellectual582695,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from chin liposuction. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hello @Intellectual582695, thank you for your question. There is difference between the first, second and third thirds of the face. A long branch chin implant would help the harmony of the face to be more proportioned and that you can see a proper jaw definition. Any other non-surgical treatment such as radiesse would only give projection to the chin but not the harmony you are looking for. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. Best wishes! Alan Gonzalez MD, FACS.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You seem to be a good candidate for liposuction under local anesthesia with skin tightening using Jplasma. This is a congenital issue an unlikely to be corrected with weight loss or exercise. It is best to have an initial virtual consultation to discuss pros and cons.

William Portuese, MD · Answer

From the photographs presented, you appear to have significant fat deposits located both above and below the platysma muscle in your neck. Liposuction can only accomplish removal the fat deposits above the muscle which will be inadequate for you. A surgical neck lift accomplishes removal of the fat deposits under the platysma muscle which also includes a platysma plasty to significantly improve the jawline. No skin removal is required. Before considering this procedure, your BMI should be less than 30.

Darryl J. Blinski, MD · Answer

Thanks for the 1 side view posted photo. I recommend full neck lipo with My Elevate II suture mini neck lift, + HA filler to anterior chin. Fee $10,000. Best to virtual consult.

Mats Hagstrom, MD (license on probation) · Answer

All of your facial concerns stem from your facial skeletal structure.
In particular the body of your mandible lacks projection giving you a significant dental overbite with your upper lip having substantially more forward projection on your profile picture than your lower lip. On top of this your chin (The mental part of the mandible) projects substantially but the “body” of the mandible lacks length. this may seem confusing since part of your mandible is too long and part of it is too short. 
The correct treatment for this is jaw advancement. I suggest having a few consultations with local oral surgeons.
Trying to manipulate soft tissues to compensate for a skeletal problem is going to give partial improvements at best.
A lot of people have the same facial characteristics and many people are apprehensive of having the correct definitive procedure and try soft tissue manipulation like you have with very little real improvement.
Treatments should ideally be aimed at treating the primary problem and if they’re not patients need to accept inherent limitations in their outcomes.
Having a small mandible leads to all the things described above it as well as a premature double chin and premature jowls.
Plastic surgeons tend to be soft tissue oriented while oral surgeons typically see things from a bone perspective.
Young people who have facial aesthetic issues almost always have the root cause being bone related.
Best,
Mats Hagstrom MD

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