Should I do another jaw surgery, or reduce my cheekbones? (photo)

Your lower face appears slimmer than the upper face. This can happen after v-line surgery. The cheekbone can be reduced as well. I would narrow the width of your face by reducing the zygoma. The bone has two components, the body and the arch. I make two cuts on the bone, one in front of the face and the other on the side. Then I recess the bone without screws or plates and the incisions are all hidden, mostly inside of the mouth. The bone is held in position by the soft tissue. I have been performing this surgery for over 20 years. You are a good candidate for this surgery.

There its always a risk of sagging after any type of cheekbone reduction. The only way to completely avoid that risk is to not have the procedure. Whether a secondary jaw reduction would provide further benefits is not clear in your picture or description as it is not known what type of jaw reduction procedure you had initially done. It would require x-rays to make that determination. You are also correct that doing cheek and jaw reduction at the same time increases the risk of skin sagging afterwards.