Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants or lip implants), liposuction, Rhinoplasty and/or facelifts for over 30 years. Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles. From the photos, your cheeks are very flat (actually concave) in the front, the chin is very weak as are the mandibular angles, there is excess facial fat in front and below the cheeks, the nose is large S-shaped and under-rotated (make sit appear long). These combine to create a thin, elongated rectangularly - shaped face. Every face has some degree of asymmetry and while yours has asymmetry it is an average amount. The issues is the lack of angularity in the facial features mentioned above. With careful evaluation and planning an experienced facial shaping surgeon can create the required angularity to improve your appearance in a reliable and effective manner. I believe that you are being too hard on yourself but you are correct that there are areas that can be aesthetically improved. The following procedures would create a more ruggedly handsome face. Cheek augmentation with cheek implants to add angularity to the cheeks and mid face. Liposuction can be combined to reduce any excess fat to further shape the cheeks and 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.Rhinoplasty to thin and refine the shape of the nose. Cheek implants can be placed using several different approaches but using a small incision on the inside of the mouth remains the "gold standard" and most accepted manner of placement. This technique places the silastic "cheek implant" on the cheek bone itself below the tissue covering of the bone in what is called an "implant pocket or space". The tissues are closed in layers from the inside outward and a double water tight closure is done along the incision line. I have placed silastic cheek implants for 30 years in military, SWAT, LE, professional fighters, as well as actors and many regular people who are active. When placed below the covering of the bone and when the layers of the cheek are closed from the inside out, there is no need for fixation screws or sutures in my humble opinion. I do ask that all my cheek implant and chin implant patients sleep on a U-shaped pillow for 1 month following the surgery. In addition, I have had the opportunity on numerous occasions to replace silastic cheek implants (placed by others) that had been screwed into the cheek bone. During the replacement it was evident that the metal screws pushed right through the soft implant as it was tightened down on the hard cheek bone. Which makes perfect sense. So in the long run, these fixation methods alone are no guarantee that the implant won't move. Proper placement, proper implant pocket creation and meticulous closure of all the tissues layers is what is required in my humble opinion. Hope this helps.