Surgery for very narrow face. (photo)

Question

I've tried fillers. Spent about 3,000 on them and its not working. My face is narrow and cheeks look sunk in. I also feel like my nose is too large. I'm looking for owing for permanent surgery. Just no idea what to ask for? Fuller cheeks? Forehead help? Chin? Nose?

Zoran Potparic, MD · Answer

There are several procedures one can think of to correct elongated, narrow face. Visually shorter forehead (hairline forehead lift) would help, wider cheeks (cheek implants, fat grafts) and wider jaw angles (jaw implants) would create more oval, youthful face. One could also consider shortening upper jaw (set back) to achieve shorter face. In depth clinical evaluation, possibly cephalometric study would benefit to decide about best treatment plan.You should seek a consultation with an experienced board certified plastic surgeon with experience in facial implant/surgery, possibly craniofacial or experienced maxillofacial surgeon. Good luck.

Ali Riza Öreroglu, MD · Answer

Augmentation/enhancement of the mid face and the jawline can help the face look wider. Fat grafting or implants can be alternatives to fillers which can provide volumizing and contouring effects for the face. A rhinoplasty can help reduce the size of a nose. It will be best to consult a board certified facial plastic surgeon in person and discuss your goals and options after a physical examination.

Jason Emer, MD · Answer

I recommend a combination approach for facial contouring: implants for cheeks and chin in combination with facial contouring with fillers as needed. A combination of VASER liposuction and thermiRF or thermage, ultherapy, kybella can also be used to further contour the jawline. I recommend seeing an expert for a formal consultation. Best, Dr. Emer

Barry L. Eppley, MD, DMD · Answer

You would benefit by jaw angle and submalar cheek implants which would create greater facial width. Your jawline  in the back sits way inside that of your cheeks. This requires widening jaw angle implants. While your cheek bones have adequate width in the front your lack of facial fat beneath them give a very sunken in look. Submalar cheek implants will help add fullness to your sunken cheeks below the height of the cheek bones..

William Portuese, MD · Answer

A full set of facial photographs( not selfies, since they are wide-angle and parabolic) are required to make a determination about what may be needed to discuss a chin implant, rhinoplasty, and cheek implants. When patients have a flat maxilla and a flat cheek profile, cheek implants can be considered. Cheek implants  are placed through an intra-oral approach under brief general anesthesia. They can accomplish giving volume restoration to the cheeks when they are looking sunken. Cheek implants are manufactured in a large variety of sizes and shapes, and can be custom carved when necessary to match patient's unique anatomy. For more information, many examples and diagrams of the implants themselves, please see the link and the video below

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. From the photos your cheeks are flat anteriorly (in the front) but projected towards the outside of the face and the chin is weak.  These factors combine to create an elongated, rectangularly shaped face. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

Think of facial beauty as something that "must" address all layers of the face including the skeletal structure of the cheeks and chin, the overlying SMAS muscle, amount and position of subcutaneous fat and finally the degree of skin laxity. It's an "urban myth" that pulling tissues over flat cheeks and a weak chin can create a beautiful or handsome face. Similarly, dermal fillers or facial implants alone can't lift and remove excess skin from the face and neck. Natural looking beauty is created by the aesthetic vision of what tissue layers need to be adjusted by what technique and amount.

A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   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 and highly effective.  If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

very small incisions and no incisions extend or are placed within the hair.minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.Rhinoplasty can thin and refine the nose however, this by itself will not create a more feminize face overall.  I frequently combine Rhinoplasty with facial shaping procedures.Hope this helps.

David Alessi, MD - Account Suspended · Answer

A combination of cheek implants, jaw implants and fat injections would help.  Also, reducing the high hairline would balance your face significantly.  Seek out a consultation with a board-certified expert.  Best wishes.

Surgery for very narrow face. (photo)

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