Do I need a bichectomy or a lift? Or double chin lipo? Or all? (photos)

Question

I am 38 y.o, I want to improve my side profile, I was always bothered about my chubby cheeks even at normal weight and now that I am overweight, my face looks off. I feel my cheeks are sagging, I was told it’s not good idea to remove buccal fat when you are older, bc it makes you look older...I just want to understand what is the right procedure I should do or where to start... P.S. I plan to try chin filler and do double chin lipo but now I think the biggest issue is the cheeks.. Thanks!!

Benjamin Caughlin, MD, FACS · Answer

This is a great question. I have good news. I do think buccal fat pad sculpting is the key. Possibly some microfacial lipo and or chin lipo but often times the buccal fat pad can be removed, sculpted and repositioned to the point of making the difference you are looking for. What people "want" is  a shadow under the cheek prominence as well as the jawline. This allows for a contoured look. We would need to do a good physical exam but I think it is a great procedure and could get you what you are looking for. Happy to expand.Hope this helps,Best of luck,DrC

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It seems like you can benefit from a chin liposuction and necktite is suited to tighten the jaw line and neck area. I recommend you to schedule a consultation with a board certified plastic surgeon.

Tanveer Janjua, MD · Answer

The best way to balance the face is to get fillers in the upper cheeks, liposuction along the jaw line and chin and thermitight to tighten the loose skin.You could also use a chin implant. Since you are so young, I would wait for a few more years before getting a facelift.RegardsDr. J

Victor Manuel Agudelo, MD · Answer

Hello, In suggest you a chin implant to improve your chin projection, added to a laser assisted under chin and lower face liposuction. This will improve your jawline contour and a light skin tightening effect over the treated zones.

Mats Hagstrom, MD (license on probation) · Answer

Your individual facial appearance is purely based on your facial bone structure. you don’t have anything abnormal about the soft tissue covering other than being slightly overweight.
In your case your mandible is small and lacks projection.  this can cause the lower 1/3 of the face and neck to have undesirable characteristics.
In comparison your maxilla is tall.
Soft tissue manipulation can make slight improvements but it is not addressing the fundamental problem at hand.
People with an under developed mandible often have a dental overbite. 
Treatment options include chin implants including the angle of the mandible, sliding genioplasty and augmentation with fillers.
There are more drastic cranial facial surgery options but they are probably not something most people would consider.
Understanding with the primary problem is sometimes helps people accept the limitations for treatments that don’t address the problem.
Chin and neck liposuction often given stellar results especially in those who don’t have skin laxity. even if it doesn’t address the problem it often gives very impressive results.
Sometimes oral surgeons do a better job at making proper cephalometric assessments of this condition and can offer more definitive treatment options.
Plastic surgeons vary in their experience, education and level of comfort doing facial skeletal surgery.Personally I don’t think you should get buccal fat pad reduction. Other providers may be stronger proponents and it could look good but some patients end up paying the price as they age.
Best, 
Mats Hagstrom MD

Do I need a bichectomy or a lift? Or double chin lipo? Or all? (photos)

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