Face is slightly aging with a boxiness look. Would I benefit from a chin implant? (photo)

Question

Addressing a few options at the moment, fat grafting , chin implant , possible lower face lift. Thanks in advance for your opinion.

Jason Emer, MD · Answer

This will depend on the final results you want. Symmetry and contouring of the face can be improved with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. This will allow you to try on the look before committing to a permanent option like fat or implants. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Your chin could be made to have better projection. If you’re not sure you’re ready for surgery, but still want to improve and strengthen your chin and profile, I’d suggest augmenting your chin with Sculptra and/or Voluma. If you like your new look, you can make it permanent with a chin implant. Hope this helps.

Ryan Chastant, MD · Answer

Thank you for your question. If you are looking to explore your options for augmenting your chin or lower face, I recommend scheduling an appointment with a board certified facial plastic surgeon. They can examine you and offer the best advice as to what would help you achieve the results you want. That being said, you are probably not a candidate for a facelift at this point. Facelifts are generally the last step after you’ve exhausted all your other options. Fillers can help shape your chin without surgery to get an implant, and injectable treatments like Kybella can address the excess fat under your chin, as can other non-invasive contouring treatments. Good luck!
- Ryan Chastant, MD

Faisal A. Quereshy, MD, FACS · Answer

Great question.  We see the first signs of aging occur near the jaw line contour and chin/ neck regions. Most commonly the "marionette lines" around the mouth and the indentation on both sides of the chin become pronounced.  These early changes are hallmarks for chin recession or "shrinking volume" in the chin region.
The best predictor if a chin implant would work is to allow the doctor to suggest a temporary correction with a filler :  a non surgical chin augmentation. The advantage is immediate correction with an injectable, no surgery or downtime, and results that would mimic a permanent chin implant procedure.  
Chin implants are wonderful permanent options to rejuvenate the jaw contour and minimize neck fullness.  Hope this helps!

Dr. Q

Somyos Kunachak, MD - Account Suspended · Answer

hi waterjo88,
Based from your photos, it looks like you have a prominent cheekbone with a relatively hollow cheek, fat transfer will balance this out and improve your facial harmony. For the lower face, it doesn't seem like you have significant sagging on your jowls, and the vertical height of your chin seems adequate. A chin implant with a conservative forward projection may however help mask your double chin if you want an implant.

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

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin, lips), liposuction and/or facelifts for over 30 years.  From the photos, your left cheek is quite flat in the front, the right has a mid cheek groove indicating some tissue sag off of the cheek, there is evidence of some "jowls" in the lower face, the chin is weak as are the back portion of the jaw line and there is slight amount of excess skin under the chin.  These combine to create an elongated, oval shaped face.  
 Following my beauty principles, 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.  When the cheeks are flat or concave 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.
 I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  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, highly effective and far less invasive than a sliding genioplasty.  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.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).  
 I have performed many facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts on women in their late twenties and early thirties.  From the photos your cheeks are flat in the front, jowls are present and the chin is weak.  These factors combine to create a rectangular shaped face. 
 Following my beauty principles, 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 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” are sagging facial tissues and the main 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 SMAS facelift is the minimally invasive, short incision SMAS 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 and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
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 from the face and neck
excess skin removed from the face and neck
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. Finally, a word of caution concerning the use of fat (injections/transfer) for facial shaping.  I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  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 silastic 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.

Face is slightly aging with a boxiness look. Would I benefit from a chin implant? (photo)

Answers (6)

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