Chin lipo with rhinoplasty or would fillers, Botox & fat injection slim my face? (Photos)

Question

Should I get chin lipo at same time as my upcoming rhinoplasty? Or would a combination of jawline filler, masseter botox, fat injection be enough to slim and shape my face? Worried about skin sagging after chin lipo and not sure which brand name fat injection to go for.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Daniel Barrett, MD · Answer

Dear shenad,
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

Facial aesthetics is complex. The number of providers who truly understand facial aesthetics and can make accurate assessment is actually quite low.
Most plastic surgeons tend to be soft tissue oriented and look at soft tissue solutions.
In Reality facial aesthetics is almost entirely determined by bone structure. this is especially true for young people. As people age soft tissues play a greater impact but signs of premature aging are associated with those who have less than ideal aesthetic balance in their facial skeletal structure.
Because addressing bone structure is complex and beyond what most people are willing to go through most people look at soft tissue solutions.
To approach this properly your first and foremost need a really solid assessment.
Each part of the face looks the way it does in relationship to the areas around it.
Oral surgeons tend to see things more from a skeletal perspective since they do more skeletal type surgery.
Unless you want to isolate specific parts of your face for assessment and treatment changing your entire facial appearance has to involve and understanding of your facial skeletal structure including how it can be changed.
What you were asking for is in fact very complex and could easily encompass at least an hour long consultation.
In the end you’ll have to ask yourself what you’re willing to go through and what you’re trying to achieve.
Starting at the top with those who can perform the most complex procedures will give you the best foundation and then you can work your way down. if you start at your local Medspa then you will get unsophisticated answers based on the treatment tools that those providers have available.
You don’t have an issue with that distribution. Yours is totally normal and if anything your subcutaneous fat layer in your chin and neck is thin.
You don’t have hyper activity of your muscles of facial expression. Fillers can to some extent mimic more extensive bone structure and may be an excellent choice.
This is simply not a good place for you to get a quality assessment.
Consider having multiple in person consultations with local board-certified plastic surgeons and consider also consulting with oral surgeons.
Try to get the most comprehensive understanding of your facial structures and how they relate to your facial appearance compared to what is considered ideal.
You can then go through each area and make a decision regarding treatment options and what’s important to you. 
This whole process can be very complex and doing it right with a thorough understanding of what actually causes people to look the way they do is be on what many people are capable of.
Good luck,
Mats Hagstrom MD

Chin lipo with rhinoplasty or would fillers, Botox & fat injection slim my face? (Photos)

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