18 year old female considering rhinoplasty, chin augmentation, and cheek implants? (Photos)

I'm very interested in having cosmetic procedures done, as my nose and thin face have bothered me for a very long time. I feel getting this corrected early in life will significantly impact my confidence and thus allow for more satisfaction in my young adulthood years, instead of waiting until middle adulthood or later. How much would these procedures cost, and could they be performed at the same time? Do you agree that I would benefit at my age?

Doctor Answers 13

Nose and chin surgery, then non-surgical cheek fillers


Hi. I agree with your conclusions. At your age your facial features are fully formed. Most plastic surgeons determine their plan for rhinoplasty and chin augmentation preoperatively and generally stay to their preop evaluation.  Therefore, you would benefit from asking a rhinoplasty specialist for a consultation that can show you his preop and post op simulations with a computer or with overlay drawings to let you and him/her  understand what you ultimately want for at least your profile and front view,


The most delicate part of your facialplasty  is the rhinoplasty and that would be recommended  as the first procedure. Then, the proper small wraparound chin implant would complement your profile and provide more volume than a small button shaped implant.  Alternatively,  fillers such as Radiesse can be employed for full chin augmentation  preoperatively, postoperatively, or at the same setting as the rhinoplasty.  

Subsequently, usually at the same setting and occasionally  after any minor swelling of your nose and chin settle, I would recommend a facial filler for cheek augmentation such as Radiesse or Voluma to provide the frontal and oblique view volume and 3-D shape where ever needed to complement the  new balanced look from your chin and nasal procedures. 

 Fillers such as Radiesse induce your body to generate new collagen, as they reabsorb, often leaving sufficient volume to provide lasting benefit without more than a small touch up later. Delaying your cheek and even your chin augmentation with fillers tends to be more economical, if cost is a factor. 

The talent of your plastic surgeon or rhinoplasty specialist is critical, so look at many of his/her before and after photos to be sure the specialist’s  aesthetic conforms to your own.  Your individualized simulation should be on target for exactly what you want, so your goals are understood at the outset and you and your surgeon together can make the proper decision for your natural new more balanced look that builds your  confidence, at once, or progressively.


You're a good candidate for rhinoplasty. See the morph I made. Chin and cheek implants, not so much.

Click on the "Web reference" link, just below my response, or go here:

FacialSurgery.com/RealSelf/RealSelf_hannahmh.html

I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.

I "deprojected" your nose, which means to bring the tip back closer to your face. I also elevated the bottom of your nose. That piece between your left and right nostrils is called the "columella," and it droops down more than average. The drooping columella and the forward projection of your tip also make your upper lip look very short, and you can see in the "after" morph that your upper lip is longer.

In the animation, you'll see that I lowered the bridge even up high, where your nose begins, between your eyes. That helps to make your nose look shorter: you have a tall mid-face, so even though the tip of the nose is pointing up, your nose still looks long-ish, and lowering the bridge up there helps to keep the nose looking shorter. Hope that's not too subtle a concept. 

I didn't do a great job with the morph, because the tip still look pointy to me, but deprojecting a tip always tends to keep it from looking pointy.

I don't think you need a chin implant. I suppose one could say that your chin could be fine if it projected forward more, but your chin is tall from top to bottom, and that helps it to look stronger. Then, your projecting nose makes the chin look small, so when the projection comes back, your chin will no longer look like it needs to be strengthened. See if you agree.

I like cheek implants for almost nobody. I don't think they look good, and it's almost impossible to predict on whom they'll look just okay and on whom they'll look terrible. Concentrate on your nose.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that the great majority of plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon. I can't stress this strongly enough. If your surgeon doesn't know at least the issues I described above, it's trouble.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

You also only submitted that one photo, though it seems to be the most important view. If you want a more complete evaluation, the very bottom of the Web reference page gives instructions on how to take more angles that are good for an online evaluation like this.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Rhinoplasty and chin

Hello! From your photos it does appear that you would benefit from rhinoplasty and chin augmentation. I prefer injectables to permanent cheek implants. Choose an experienced facial plastic surgeon. Photo morphing will help you assess what is possible with your features. Good luck!

Catherine Winslow, MD
Indianapolis Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Rhinoplasty at 18

I agree that proceeding with rhinoplasty at this stage in your life is reasonable.  You have significant columellar show and alar retraction.  These problems can be tricky to correct, so be sure to consult with a surgeon who has interest and experience in these aspects of rhinoplasty.  You might want to hold off on procedures on your chin and cheeks, as you may be satisfied with the overall aesthetics of your face after rhinoplasty alone.

Eric T. Waterman, MD, FACS
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 7 reviews

Rhinoplasty, cheek implants, and chin implant?

 Both the rhinoplasty and chin implant would give you a very good result if properly done. Cheek implants would depend on other views that I would need to see to determine how much and if your cheeks do in fact need to be augmented. Make sure you see a very experienced surgeon can show you good  results from these procedures. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

These procedures will benefit you

Cosmetic benefits of rhinoplasty, chin implants and cheek augmentation but not cheek implants are not deniable in your case. Cost varies from surgeon to surgeon. That will require personal home work on your part.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Rhinoplasty, Cheek and Chin Implants

The one picture does show a large nose with a hanging columella that could be improved with a rhinoplasty and suggests that cheek and chin augmentation would be beneficial. A full set of pictures as described on my website would be helpful. All of these procedures can be done during the same operation.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

18-year-old female considering rhinoplasty, chin augmentation and cheek implants

From the one limited photo, it appears that there is an overly projecting nose with a dorsal hump and  a hanging columella for which a rhinoplasty can improve. A full set of facial photographs are required due to the fact  that the face is a three-dimensional structure and all three procedures are performed in a three-dimensional fashion. The photograph also reveals a weak and recessive chin profile for which a small chin implant can improve the projection of the chin to help  with facial balance and proportions, especially with respect to the overly projecting nose. Probably best to start with rhinoplasty and chin implant for now. Digital computer imaging can also be helpful to understand what can be accomplished with these two procedures on your face. For more information  and many before-and-after examples of this combination,  please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Nose, Cheeks and Chin Changes

You should have some computer imaging to see how these facial changes will look on you. But if rhinoplasty and cheek and chin augmentation looks good to you then you would get great long-term benefits when done at your young age.

Rhinoplasty and Chin Implant

Your age is very appropriate for both rhinoplasty and chin augmentation procedures, and the combination is often dramatic in a good way.  Certainly those procedures are done together very commonly.  You may not need cheek implants as our options now include fat grafting and fillers like Restylane and Juvederm and are very good and more simple. The cost varies quite a bit depending on where you live, so call around to several offices to get estimates and go from there.  Base your decision on the in-person consult, though, not price, and choose a skilled and experienced plastic or facial plastic surgeon.

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.7 out of 5 stars 18 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.