Chin reduction options - 48 y/o Female. Surgery? Lipo? (photos)

Thank you for providing photos. I am not in favor of any chin reduction surgery in your case. This might shorten the distance between your chin and neck. There is extra skin in your neck and jowl area and a surgical neck lip to tighten the skin will give you a well contoured and youthful neckline. The area around your marionette lines can be improved with fillers or fat. Botox can also be used to help weaken the muscles that depress the corners  of your mouth and turn your smile upward.

Good question.  The best type of procedure for you would be soft tissue augmentation.  Unless there is a diagnostic reason to perform bony surgery, it is usually not necessary.  The soft tissues around the mouth and chin can be augmented with fat transfer.  This is much better than filler because it is your own tissue and you can add as much that is needed.  Filler products are done by the syringe technique and there is no permanence with these either.  Fat transfer is long term and permanent.  The chin crease can be reduced and the overall shape can be improved as well.  In my practice I call it the Peri-Oral region and I enhance this on every facelift patient.  Fat transfer is a good procedure for this area rather than bony surgery.  A consultation in person is the best way to start.  I hope this helps.

Reduction of a bulbous chin requires excision of part of the soft tissue chin pad. This is done from a submental approach.

You should consider a chin and neck tuck which will improve the over all appearance of your neck and chin; an examination will be necessary by a plastic surgeon to ensure that you dentition does not need alteration, meaning that your concerns can be corrected with just soft tissue alteration.