Is my lower third (base of nose to chin) too short compared to the rest of my face? (Photo)

Question

Recently, my orthodontist measured my jaw and told me that my lower third was 61mm. I didn't think much of it until I read that the average lower third length of an adult male is closers to 80mm. I know that is relative since someone with a bigger, wider face will likely have a larger lower third, however, in pictures the lower third of my face does seem quite short, especially my chin. Is that the case, and if so what can I do about it? Are fillers an option? Chin implants?

Jonathan Kulbersh, MD · Answer

You have a few options to achieve a stronger-looking chin and profile. If you’re not sure you’re ready for surgery, but still want to improve and strengthen your profile, I’d suggest augmenting your chin with Sculptra and/or Voluma. I’d also remove the fat underneath your chin with liposuction or Kybella. If you like your new look, you can make it permanent with a chin implant.

Karthik Ram, MRCS, DNB · Answer

Thanks for sharing your queries. Though anthropocentric measurements are made for the population there will be wide ranges. What is important is not the values but the ratios of lower face to rest of the face. From the photos you have an adequate chin projection. If you want to have a longer face and defined jaw you can try fillers to get a feel of how it looks later plan for a sliding genioplasty for permanent solution. Implants are not ideal choices to increasing the vertical height of chin. Consult a board certified plastic surgeon.

Barry L. Eppley, MD, DMD · Answer

Measurements aside, what counts is your aesthetic perception. Have some computer imaging done that vertically lengthens your chin and you can visually determine if that is a beneficial aesthetic change.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  From the front photo, your face is equally divided, as it should be aesthetically, into thirds (upper, mid and lower face).  There is no lack of vertical dimension in the lower third of the face however, there is a lack of forward chin projection creating a "weak" chin as as well as a lack of definition in the mandibular angles of the jaw line.  Following my facial beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 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, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  You can use a dermal filler to augment the chin however, this proves far less cost effective over the years versus permanent enhancement from a silastic chin implant. Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Is my lower third (base of nose to chin) too short compared to the rest of my face? (Photo)

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