Round face / unevenness/ recessed chin recommendations? (Photo)

Question

I have always been self conscious of my round face and I'm looking to balance out the unevenness and take care of my recessed chin. I just did 20 units of Botox in the right masseter to help the unevenness and 6 units of Botox in chin to prep for next appt to have the chin augmented with filler. Looking for more recommendations or do you think I'm on the right track to achieve my ultimate goal? Thank you

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam your question cannot be answered.  You will need to see an Oral/Maxillofacial surgeon to see if othognathic surgery, genioplasty or using an implant is best for your specific case. It should be noted that patients with severely weak jaws or abnormally functioning jaws may be better treated with other facial surgery (orthognathic surgery), although a chin augmentation may be an option at a later time. These patients should seek the advice of a plastic surgeon to determine which course is right for them. Here is some information to help you make this decision: Candidates for Chin Augmentation - Patients whose chin profiles are weak but have normally functioning jaws are candidates for Chin Augmentation. Many of these candidates have used injectable fillers in the past to strengthen the protrusion of their chins, but are looking for a permanent solution. If you are one of these patients, then you are a likely candidate for chin augmentation
#weakchin #chinimplant

Jeffrey Watson, MD · Answer

You look great and some minor things will make you very happy. Regarding chin augmentation, filler or implant are both great options. Only downside to filler is that in a few years you've spent more than you would have on surgery. 
I hope that helps!

Jeffrey Watson, M.D.
Facial Plastic and Reconstructive Surgeon
Graduate, Harvard Medical School

Sean Maguire, MD · Answer

Based on your photos, it appears you would be best served with the placement of a chin implant. You would benefit from augmentation of the chin in both the horizontal and vertical dimensions. In addition, it appears that you have some significant asymmetry of your chin, as seen in the frontal view photo. My preferred method of placing chin implants is through a small incision underneath the chin.

William Portuese, MD · Answer

Fillers  are temporary, and do not work very well when placed in the mandible. Fillers are usually placed for patients for soft tissue augmentation, not a bony augmentation. Chin implants work quite well for patients who have a weak  and recessive chin profile, and are permanent. The implants themselves are usually placed through a small incision underneath the chin under local anesthesia as an outpatient surgical procedure. Chin implants are manufactured out of solid silicone, can be custom carved when necessary, and are manufactured in a large variety of sizes and shapes.

Barry L. Eppley, MD, DMD · Answer

The two most important changes you can make to your face come from a chin augmentation and central facial defatting. Filler is not an ideal approach to your chin deficiency unless you simply want to test how a little bit of chin augmentation would look. Your chin is deficient in several dimensions (vertical and horizontal) and filler will not approximate the real type of chin augmentation change you really need.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  From the photos, your chin is very weak.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 The silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 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, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.   You may want to hold off on further treatments to decrease your Masseter muscle(s).  From the one profile view, the back portion of your jaw line is very weak (curves inward)...the other side may also be weak.  In that scenario, I use a dermal filler (precisely placed) to enhance the back segment of the jaw line without masculinizing the jaw or face.  Weakening (decreasing the master) will only make the back jaw area look even smaller and further out of balance in my humble opinion.  In my experience effective Botox doses to decrease masseter size are closer to 50 - 60 units per side.Hope this helps.

Gerald Wittenberg, MSc, DMD (retired) · Answer

Typically, the facial fullness and 'roundness' we see, relates to the lack of prominence of the lower face/jawline. When the jawline is 'weaker / less wide/defined', the focus is on the cheek fullness. So the usual key is not the reduce fullness (aging effect); but to properly balance the jawline/chin area. Fillers are not ideal since you want to alter the actual structure of the underlying bone support - more natural look

Round face / unevenness/ recessed chin recommendations? (Photo)

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