Which procedure would best benefit my profile? Concerned about jaw line definition, jowls and bulbous nose tip (photo)

Question

I am really unhappy with my profile. I have little jawline definition, genetic jowls, and a bulbous nose tip that dips when I smile. What procedure(s) would be most effective at correcting my profile?

Jason Emer, MD · Answer

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is 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 acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. 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

Daniel Barrett, MD · Answer

Dear de_mmar,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

William Portuese, MD · Answer

Much more information is needed, such as a full set of facial photograph from all angles, and your age. From the one limited photograph, it appears that you have a recessive chin, therefore consider placement a small chin implant to  augment your chin forward for better facial balance and proportions. In our practice, this procedure can be performed under local anesthesia as an outpatient procedure which usually takes about 30 minutes.

Darryl J. Blinski, MD · Answer

Only 1 posted side view photo? My guess is mini face/neck lift with SMAS Plication/sub mental lipo/chin implant or Volux fillers to chin/tip rhinoplasty. Fee $12,000 Best to virtual with …

Mats Hagstrom, MD (license on probation) · Answer

Based on what you describe a tip rhinoplasty with a sliding genioplasty or chin implant combined with chin and neck liposuction sounds ideal.
I recommend having multiple in person consultations with local board-certified plastic surgeons in your community.
Bring pictures of your own face taken the same way plastic surgeons take before and after pictures. It should be a true frontal picture without facial expression and a true profile picture without facial expression taken at proper angles from about 6 feet away with a camera at the same height as your nose. Have someone else take the pictures or use the timer on your camera
It’s always good to bring pictures of yourself with you during in person consultations.
Scheduled multiple in person consultations with local board-certified plastic surgeons in your community who seem to have experience with the three procedures.
Sometimes it’s better to have different doctors do different parts of the work. Sometimes oral surgeons have more experience with the sliding genioplasty for example while some plastic surgeons specialize in rhinoplasty.
During each in person consultation ask each provider to open up their entire portfolio and show you their entire collection of before and after pictures of previous patient who had similar facial characteristics to your own. Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped. ask providers what their revision rate and what their revision policy is.
Ask them to only show you pictures of previous patients who had similar facial characteristics to your own.
Bring printed copies of your own pictures for reference.
An experience provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures.
Start with at least five consultations and considering scheduling more if needed.
Take careful notes during the consultation about the overall thoroughness of the consultation and especially about the quantity and quality of before and after pictures.
Review lots of before and after pictures for all three of the procedures so you have a good understanding of what could result look like. when reviewing before and after pictures make sure you’re only looking at people who have similar facial characteristics to your own in the before pictures.
Candidacy matters massively when it comes to outcomes.
There’s no point of seeing results on patients who had different candidacy for the procedure then yourself.
Create a reading system for results and document both the ratings and the number of before and after pictures each provider showed you during the consult
Being shown a handful of preselected images most likely representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures anyone the surgeon has actually performed.
When in doubt slow down and schedule more consultations.
Personally I recommend people avoid virtual consultations whenever possible and I highly recommend against traveling long distances for elective surgical proceduresBest,
Mats Hagstrom MD

Which procedure would best benefit my profile? Concerned about jaw line definition, jowls and bulbous nose tip (photo)

Answers (6)

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