Nose/chin/buccal/neck; can I have your thoughts? (Photos)

Nose smaller, chin implant or enhancement (it is very ball-like in shape and inverted. Some buccal fat removal and/or removal of skin/fat from my neck area. I am a petite, 29 year old woman - I only weigh 115 lbs, and if I tilt my head down in the slightest I have a double chin. Please let me know your thoughts! I am also in the Long Island/NYC area and doctor suggestions would be helpful.

Doctor Answers 2

Chin implant Candidate

Without an exam your question cannot be answered. However, your photos are helpful and you are probably a good candidate for a Chin Augmentation. You will need to see an Oral/Maxillofacial surgeon to see if othognathic surgery, genioplasty or using an implant is best for your specific case. It should be noted that patients with severely weak jaws or abnormally functioning jaws may be better treated with other facial surgery (orthognathic surgery), although a chin augmentation may be an option at a later time. These patients should seek the advice of a plastic surgeon to determine which course is right for them. Here is some information to help you make this decision:
Candidates for Chin Augmentation -
Patients whose chin profiles are weak but have normally functioning jaws are candidates for Chin Augmentation. Many of these candidates have used injectable fillers in the past to strengthen the protrusion of their chins, but are looking for a permanent solution. If you are one of these patients, then you are a likely candidate for chin augmentation.

Nose/chin/buccal/neck; can I have your thoughts?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that had early formation of jowls.  From the photos your cheeks are flat anteriorly (in the front), there is excess fat in front and below the cheeks,  jowls are present and the chin is weak with ptosis.  These factors combine to create a rectangular shaped face. The nose has a slight dorsal hump with a wide bridge and an under rotated (makes the nose appear long) that's a bit wide.

 Following the beauty principles outlined in my book on face and body beauty, 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.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 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 and highly effective.

 "Jowls” these are sagging facial tissues and an 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 facelift is the minimally invasive, short incision 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
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • 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. This can be combined with a Rhinoplasty to reduce the dorsal hump, thin the bridge, rotate up and thin the nasal tip for a more refined shaped nose.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.