Fat graft or removal? (Photo)

For the small contour irregularities in your photographs fillers are by far the best option. Fillers are an easy, non-surgical options that is adjustable and reversible and perfect to address these small contour changes that occur with age. Fat grafting is much less predictable and forgiving and therefore not a practical way to address these changes. Consulting with a physician experienced in facial fillers is the best way to learn more about this option.

The best treatment options will be aimed at treating the underlying problem or true ideology.

In your case the problem or diagnosis is an underdeveloped mandibal in relationship to your maxilla.

In terms of getting ideal facial aesthetics Jaw advancement would be the best procedure.

If that is not acceptable then a sliding genioplasty or chin implant is probably second-best but will not resolve the problem that your mandible does not project enough and that includes the chin and the body of that bone.

Having an under developed mandible causes a dental overbite occlusion, upper lip that has more foreword projection than the lower lip(this is related to the dental occlusion) premature formation of the double chin, lack of jawline definition and premature jowls.

Your soft tissues are normal so soft if you manipulation isn’t going to treat the primary problem.

Results from procedures that don’t address the primary problem will give limited improvements at best.

I suggest having a few in person consultations with local board-certified plastic surgeons and oral surgeons.

Regardless of what surgical procedure you opt for it’s a good idea to understand all treatment options and what the fundamental problem is.

Understanding that the primary problem is based on bone structure helps people accept the limitations of soft tissue manipulation.

Best,

Mats Hagstrom MD