Is chin/jaw liposuction the best procedure for me to get a sharper jawline? (photos)

Question

6’4” 185lbs Male. I want to rule out that the area is not due to any recession like the mandible, maxilla, or chin. If so what alternative procedures is best?

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

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

Michael P. Morrissette, DDS, FACS · Answer

Yes, submental and jawline liposuction would be a good start. However, mandibular angle implants are another option to provide an even more chiseled appearance.

Daniel Barrett, MD · Answer

Dear marcmusolf96,
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

Mats Hagstrom, MD (license on probation) · Answer

The lower 1/3 of the face is complex and making assessments is not easy or straightforward.
Almost 100% of people seeking liposuction of the chin and neck have some underlying facial skeletal bone imbalance. Almost universally these people had some issue with the mandible being small or lacking in projection.
Mandibular issues can be in different parts of the mandible.
You can’t judge the mandible by how your chin looks. The chin for the tip of the mandible is only one aspect of this phone. it’s very possible to have a Mandible that’s overall too small with a pointed chin or a projecting mentalis. The relationship between the Mandible and Maxilla can be assessed by observing someone’s dental occlusion. individuals with a small mandible will tend to have an overbite occlusion. This typically presents with certain relationship between the upper and lower lips.
The position of the lips is directly related to where your teeth sit and the position of your teeth is directly related to the shape and size of your mandible and maxillary.
In your case your chin looks strong and has forward projection.
At the same time your upper lip has significantly more forward projection than your lower lip. If you had a strong projecting mandible then your lower lip should project more than your upper lip since most people have a lower lip that’s bigger than their upper lip.
In someways you have both a large and small mandible. it’s deficient in the body of the mandible but has sufficient projection in the mentalis region.
The shape of the mandible has a strong influence on how the underlying platysma muscle drapes the neck. A long projecting mandible typically results in a very well defined jawline. there’s also typically leads people to not develop a premature double chin and also prevents people from getting premature jowls.
A mandible that’s lacking in projection will lead to the platysma draping the neck in the more oblique fashion. This in turn causes a lack of jawline definition, premature formation of a double chin and premature jowls.
Advancing the mandible behind the molars is fairly complex surgery did most people don’t want to consider.
Plastic surgeons are generally soft tissue oriented and will often make assessment based on soft tissue and surgical recommendations based on soft tissue.
You do not have an abnormal fat distribution.
Your primary problem is not an excessive amount of subcutaneous fat in the lower part of your face.
Facial aesthetics especially on young people is almost purely based on bone structure. it is a bone structure that determines if someone looks masculine, feminine, attractive or not so much. facial aging is in part related to bone structure but is more related to changes in soft tissues.
Oral surgeons tend to be far more focused on bone structure and their assessment and treatment options.
Because so much of facial appearance on young people especially in the lower 1/3 of the face it’s related to bone structure I recommend patients consider consulting with both plastic surgeons and oral surgeons.There is some overlap in the two medical fields and both specialties contribute to facial aesthetics on this part of the body.
Liposuction of the chin and neck can give a very good improvement especially on young people who have excess subcutaneous fat.
Chubby young people can get really impressive results from doing liposuction.
Middle age or older individuals with thin layers of subcutaneous fat see virtually no improvement from doing liposuction.
Procedures should be based on first and foremost having a clear understanding of what the problem is.
If you choose a procedure that doesn’t address the primary problem then you should at most expect a partial improvement.
In your case you may get different opinions from different providers.
This often happens when there is no clear obvious diagnosis or treatment options are very complex.
There’s nothing wrong with having liposuction of your chin and neck but recognize that you don’t have a fat distribution problem.
It may seem puzzling to realize you have a Mandible that’s both too small and too big at the same time. 
overall your face looks relatively normal and I don’t see a strong indication for having surgical intervention.
There are facial ideals and those who are born with perfect genetic facial aesthetics should consider themselves grateful.
Facial aesthetics is a spectrum and different people have different levels of tolerance and threshold for when surgical intervention is appropriate and when it’s not.
Lots of people want what they don’t have.
To get more accurate assessment and better understanding of treatment options I suggest having multiple in person consultations with both plastic surgeons and oral surgeons in your community.
I do not recommend virtual consultations.
I also do not recommend people travel long distances for elective surgical procedures.
Best,
Mats Hagstrom MD

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