Procedures to Improve Bottom Heavy Face?

I would like to have surgery to improve my jawline but I'm confused about my options. I assume I will need Liposuction, but what about the neck bands and the front profile?

Would it be a Neck lift, lower Face Lift, short scar facelift? I am not quite 40 yet, but close. No Chin implants please. I know my profile shot shows a weak chin, but when I smile my chin comes out to play, and I am quite happy with it.

Doctor Answers 19

Procedures to improve bottom heavy face

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The archetecture of the face and neck must be considered as a whole to evaluate balence, equilibrium and harmony. Your pictures only show half the story, but from what I see I feel 2 treatment options could be pleasing.

1. Suction of the neck and jaw line to remove your submental fat pocket and define your neck/face junction. I do not see neck (platysmal) bands in your photos.

2. A short scar face lift with neck liposuction

Bronx Plastic Surgeon

I might be crazy but...

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keeping in my mind the photos tell only a portion of the story I will address what I see only.

based on your neck, skin quality and jawline a facelift would be just too much.  I dare say you look younger than your age. I know you want to look better not younger but remember 10-20 years from now your goals will be to look yonger. ironically overtreating the fat in the lower third of your face may leave you unhappy in the future.  I just answered a question from a pt who had neck irregularities after liposuction of the neck.  I think the fat you have is possibly too deep for lipo and that procedure may leave you with banding and fullness. there are two new things you might want to look into: 1. zerona- releases fat without killing fat cells so theoretically irregularities are not possible and it does not require surgery, injections or any recovery, 2. Iguide neck lift to support muscle layer with minimal downtime. I recently started to consider these options for my pts just like you. hope this helps.

p.s. I hate chin implants. I agree with your asessment.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Improving bottom heavy face

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Judging from your pictures, you have a youthful face/neck contour at age 39. There is a small of fullness of your neck under your chin and this could be judiciously and conservatively liposuctioned. Your pictures do not demonstrate

neck bands

or significant excess skin. Therefore, at your age and with your demonstrative findings, I do not think that a

neck lift

or lower


is necessary at this time.

Procedures to Improve Bottom Heavy Face

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A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.
During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Bottom- Heavy Faces

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Thank you for your question.

Possible procedures include:
  • Suction of the neck and jaw line to remove your submental fat pocket and define your neck/face junction
  • A short scar face lift with neck liposuction

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 180 reviews

Liposuction could be the answer...

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Although your pictures are helpful, it’s hard to make a recommendation without performing a physical examination. Your pictures suggest submental fat deposition with surprisingly minimal skin laxity. Some of your lateral pictures suggest redundant skin but your head appears to be turned to the side. Under these circumstances, skin folds would be expected.
Based on these findings a facelift probably isn’t indicated under these circumstances, treatment of submental fat with conservative liposuction would result in excellent contour improvement.
If you’re considering treatment of this problem, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to perform an examination and make an appropriate recommendation.

Facelift for bottom heavy face

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The basis of a facelift is not pulling the skin rather it is repositioning of tissues under the skin and then re-draping the skin over the more youthful understructure. In some patients neck liposuction, fat grafting and other procedures to the eyes or forehead are done concurrently.

Lower face and neck options

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from what I can see, Liposuction would give you a good degree of improvement, and if a small platysmal band is palpable, the submental incision could be extended and those sutured together. I do not think you have enough skin laxity in the neck at the present time to warrant the neck lift scars.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

A chin implant would be placed against the bone of your jaw so that it feels like an extension of your natural jawline

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While you are not fond of the idea of the chin implant, that may still be the best choice.  A chin implant would be placed against the bone of your jaw so that it feels like an extension of your natural jawline.  Not only would this improve your jawline and front profile, but it would also improve your side profile and the contours of your neck.  I believe that a facelift or neck lift are more aggressive approaches than you need at this point.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Improving "Bottom Heavy" Face

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Liposuction would be helpful as part of a facelift or necklift, not as an isolated procedure. I would recommend a facelift if you do not want a chin or chin-jowel implant; otherwise a necklift with chin implant should be considered.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.