Uneven jawline, crooked chin (Photo)

Question

My chin is uneven, and has been bothering me quite a bit. Even with a beard it is noticeable. What type of treatment is available to create a more symmetrical face. I'm currently 6 months into orthodontic treatment, but they told me it won't help the uneven chin at all.

Sam Rizk, MD · Answer

Hello, and thank you for sharing your question and photographs. While orthodontic work improves the appearance of your smile, it has no effect on the shape of your chin or jaw line. A weak chin can be addressed with the addition of synthetic fillers. A chin implant and augmentation improve facial balance and will help you achieve the symmetrical face you desire. Chin surgery is safe and adds a sculpted, masculine balance to your appearance. Meeting with a board-certified facial plastic and reconstructive surgeon would allow for a more personalized consultation

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam your question cannot 
be answered.  You will need to see an Oral/Maxillofacial surgeon to see 
if othognathic surgery, genioplasty or using an implant is best for your
 specific case. It should be noted that patients with severely weak jaws
 or abnormally functioning jaws may be better treated with other facial 
surgery (orthognathic surgery), although a chin augmentation may be an 
option at a later time. These patients should seek the advice of a 
plastic surgeon to determine which course is right for them. Here is 
some information to help you make this decision: Candidates for Chin 
Augmentation - Patients whose chin profiles are weak but have normally 
functioning jaws are candidates for Chin Augmentation. Many of these 
candidates have used injectable fillers in the past to strengthen the 
protrusion of their chins, but are looking for a permanent solution. If 
you are one of these patients, then you are a likely candidate for chin 
augmentation
#weakchin #chinimplant

Michael P. Morrissette, DDS, FACS · Answer

There are many options to choose from. A temporary improvement can be achieved with fillers. A permanent solution may require a custom implant or genioplasty. A consideration must be given to whether or not you have a posterior jawline asymmetry that you want corrected. Again, fillers, implants, and corrective jaw surgery may be an option. Find a surgeon who performs all these procedures and make a consultation appointment. Your orthodontist may have a recommendation.

Jonathan Kulbersh, MD · Answer

You have a few options to improve the symmetry of your chin and jawline. If you’re not sure you’re ready for surgery, but still want to improve and strengthen your chin and jawline, 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. I hope that helps.

Barry L. Eppley, MD, DMD · Answer

It is no surprise that the chin and jawline are correct so if one is off so is the other. With jawline asymmetry the first step is make the diagnosis with a 3D CT scan of the lower jaw and then match that up with your external facial appearance. Many jawline asymmetry problems are best treated by augmenting the deficient side or sometimes it takes the entire jawline to be augmented differentially to create the best external symmetry. It is not as common or usually has successful to reduce the large asymmetric sides of the chin and jawline.

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

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  Orthodontic treatment will properly align the teeth but have no effect on the volume of chin or jaw bone.  The photos does show a weaker left chin and jaw line.  I suspect that the chin itself is weak which can be confirmed with a profile photo.  The cheeks are quite flat in the front which accentuates the asymmetries in the lower face.  Ideally, the cheeks should have angularity as discussed below. Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  The following procedures would create a more ruggedly handsome face.
Cheek augmentation with cheek implants to add angularity to the cheeks and mid face.  
Chin augmentation, using a chin implant, to add projection to the chin creating harmony and balance to the lower face.  I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  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 bone segments).  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.  
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.
 The cheeks, chin and jaw line can also be augmented with precise placement of a dermal filler to shape and increase symmetry.  However, the use of a permanent filler or fat (transfer or injections) should be avoided due to increased unwanted side effects and unreliable long term effects. 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

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