It's like my face just melted and made my jaw disappear. What's the surgery/treatment that would fix this? (Photo)

Question

I've had treatments that haven't worked (like filler) & am not sure if I'm ready for a full on facelift (early 30's!) but I'm lost. I have heard many different things and am unsure of what would work. Chin lipo? threads? Something to do with my jaw or chin? I would rather address the whole thing at once to see my jawline again when I'm sitting up (can be seen when I lay but gone once I sit upright) but It's hard to tell what would be effective when I hear different things by different consults

Gurkan Kayabasoglu, MD · Answer

Hello. Despite your young age, the only thing that will give you the look you want is face and neck lift surgery. No fillers and hangers will give you this look. It will only have a short-term 1-2 month mild effect, but you cannot gain the appearance in the photo you sent from procedures other than facelift. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the seminar invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me. With all respect.

Raffy Karamanoukian, MD, FACS · Answer

A non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Jeffrey Lisiecki, MD · Answer

First off, you should be seen in person and I would be curious to see (and feel) where your prior filler is, but based on your description and photos, you could do well with submental liposuction and radiofrequency skin tightening, as well as potentially some filler to the jawline itself (though it's tough to see on your photographs alone). Best of luck!

Christopher W. Robb, MD, PhD · Answer

You would definately benefit from a little chin liposuction and MyEllevate thread. You can check out their website for more information and for a qualified surgeon in your area.

Darryl J. Blinski, MD · Answer

Based on the posted photos I recommend mini FL/NL SMAS plication with HA fillers (4-6 syringes or nano fat grafts to jawline, sub mental lipo. Fee $12,000. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

Cosmetic surgery is no different than any other form of medicine. The process begins by making an accurate diagnosis.
Anesthetics we sometimes call that making an assessment.
There are various tissue layers that can be treated and affect our appearance. It starts with the facial skeletal structure which is covered by various functional tissue layers finally The platysma muscle of the neck, subcutaneous fat and skin.
The difference between individual people‘s facial appearance especially people who are young and have not had influences by obesity or weight fluctuations is purely based on bone structure. it is the facial skeleton that says this person is attractive and that person is not. This person is masculine and that person is feminine etc.
Soft tissue coverage tends to be extremely consistent from person to person.
In your case it is your facial skeletal structure that creates the appearance you don’t like.
In particular you have a small mandible in comparison to your Maxilla.
Your mandible is both small and vertical height overall dimension and projection.
If you want to address the primary problem then I suggest consulting with oral surgeons or board-certified plastic surgeons with craniofacial backgrounds. 
Attempts of soft tissue manipulation when the problem is based on skeletal structure will lead to partial improvements at best.
Patients need to be careful that they don’t keep pushing for treatments that are not addressing the primary problem and can eventually create problems related directly to the procedure. For example if somebody apps for Liposuction with a provider excited to show what they can do but the results are disappointing it may be tempting to push the provider to do a revision.
Since fat distribution wasn’t really the problem removing fat isn’t going to address the primary problem and doing more of the same will eventually lead to an abnormal fat distribution which now creates two problems for the patient.
This is not to say that Liposuction cannot be helpful because often it can.
The best treatments will always be aimed at treating the primary problem directly as much as possible.
If you seek the advice of providers who like formal education or years of experience then you are likely to get a variety of different opinions since they are in capable of actually recognizing what the primary problem is. this would be typical in a med spa situation.
I suggest getting formal consultations starting with the most complex and involved procedures and working your way down the list of treatment options before choosing what is correct for you.
The worst thing you can do is spend money on procedures that don’t work or make things worse.
Unfortunately creating a large Amanda bowl is fairly complex and limited to some degree.
Talk to craniofacial (Oral/plastics with Fellowship) surgeons about what they can and cannot do.
Sometimes working with fillers can create remarkable improvements but there is an a Normas discrepancy in skill and training and providers working with fillers.
To see examples of what can be done working with fillers alone I suggest you look at the website of Dr. David Mabrie MD in San Francisco. He has a facial plastic surgeon who no longer does any surgical procedures and only works with fillers.
It will give you an idea of what the gold standard is and what can be accomplished if you choose the right provider.
In the end finding the right people to work with even if it means having a different procedure is often the most important variable.
To find the right provider often means having a lot of consultations.
Consultations should ideally be done in person and during consultations ask providers to show as many before and after pictures of what they recommend as possible.
Ask them to show you examples of patients with similar facial characteristics to your own in the before pictures.
I’m not surprised you found the process confusing and complex to date.
The truth is that it is.
Good luck,
Mats Hagstrom MD

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