Rhinoplasty or Chin/Jaw augmentation? Or something else? (photos)

The face is generally divided into thirds - the upper face (forehead) the mid face (from the top of the nose down to just below the nose) and the lower (from below the nose to the bottom of the chin). In general these should be equal thirds for balance (though some very attractive people are a little off). This is true from the front and the side. In addition, especially from the side, the amount that the face projects in each third makes a difference. In your case your nose over projects. In addition your chin is slightly under projecting. Together this makes your convexity look a little more extreme. This is a perfect situation for a combination of rhinoplasty and chin augmentation (usually using an implant). I agree with your description of your forehead. Forehead recontouring can certainly be done though it is a bit more complicated because it has to be built up, usually using an acrylic. I recommend doing this afterward as you will most likely be very happy with just the rhinoplasty and chin. Good luck.

Thank you for the question. A rhinoplasty to reduce the dorsum of your nose and define and deproject your tip would benefit you. This can be combined with chin implant placement or fat grafting to your chin in order improve your profile. However, an in-person examination is necessary in order to make an accurate assessment. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Your nose, chin, and forehead: your analysis is very perceptive and is correct. Your nose projects too far forward. Your chin is slightly weak, and your forehead recedes backwards. The over projecting nose makes the chin look even weaker and put the other way around the weak chin and receding forehead point all vectors to the middle of the face and the nose which is the most projecting part. Reduction in the size of the nose would be the most obvious thing to do and have the most impact in bringing your features into better harmony. A small chin augmentation aimed at increasing the forward projection of the chin would also help.

The side profile photographs demonstrate an overly projecting nose and an under projecting chin. Th under projection of the Chin makes your nose look larger than it really is from the side profile photograph. Consider a closed rhinoplasty to shave down the dorsal hump, reduce the projection of the nose, refine the nasal tip and narrow the bridge line with all the incisions placed on the inside of the nose. Also consider placement of a chin implant to augment the chin forward for better facial balance and proportions. In our practice, we use Implantech brand of solid silicone chin implants placed through submental approach. The chin implant can be performed at same time as the rhinoplasty under general anesthesia, or as a stand alone procedure under local anesthesia.

Nasal cosmetic surgery and a chin implant are frequently performed together in the appropriate patient. The ideal aesthetic result should be individualized to achieve harmony with your other facial features and improve the areas that concern you. Whether a chin implant or a more extensive jaw surgery would be optimal depends on multiple factors including your desired outcome and personal anatomy.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you what to do based on limited photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. The extent and length of the procedure, cost, and the specific operative steps to achieve an ideal cosmetic result vary from patient to patient and would depend on the findings at your consultation examination.

Robert Singer, M.D., FACS

La Jolla, California

Hello. Looking at your profile, it appears your dorsum (bridge) and tip are somewhat over projected (standing too far forward). It’s a bit risky to try to bring your chin contour forward to be in balance with your tip position as you’d likely have both a nasal tip and a chin that now protrude unnaturally. My feeling is a proper reduction in dorsal prominence and tip prominence would create better facial harmony and a better nose/chin relationship. As an exercise, you can place a pencil between the tip of your nose and your chin and your upper lip should be about 2mm behind the pencil and lower lip about 4mm. Hope this helps

Hello and thanks for your question. According to your pictures, you are a very good candidate for the rhinoplasty operation. Considering the position of your chin and your face structure, I strongly suggest you to have chin augmentation procedure. You can have chin implant or fat transfer to chin operation. I strongly advise you to decide your procedure after you have in-person consultation with the board certified surgeon.