Procedures to slim lower face/cheek area? (Photo)

Question

I have tried buccal fat removal and removed all of it and it did help slim the mid area of my face, but my lower cheeks are still big. I tried jaw botox already too for a year and had 4 rounds with 30 units on each side each round and nothing has changed. What other procedures can I do to get rid of the bulge? also I am not interested in jaw shaving.

Alan Gonzalez, MD, FACS · Answer

Hello @lileevee8, thank you for your question. A consultation is essential to develop a surgical or non surgical plan that meets your needs, fulfills your expectations, and takes into account what can actually be achieved. During your consultation, your surgeon will be able to assess your unique needs and develop a treatment plan that is tailored to your needs. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Sam Speron, MD, FACS · Answer

Surgical contouring is a great way to get a slimmer face/cheeks/chin.

There are also several nonsurgical options to consider. Some can be done at the same time. Surgery combined with injections and laser treatments before or after surgery is usually the biggest difference.  For people not interested in surgery, Botox, hyaluronic acid injections and laser treatments are the most reasonable options, maybe combined with a chemical peel.
These procedures can be done safely in the office and the results are often very satisfying. An in-office private consultation and examination with a board-certified plastic surgeon would be the best way to fully address your specific concerns and determine the right treatment plan.

I hope this helps answer your question.  If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Daniel Barrett, MD · Answer

Dear lileevee8,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I am not a fan of removing facial fat since this will age you more when you are older. You can do micro-needling with radiofrequency to help tighten your skin.

Mats Hagstrom, MD (license on probation) · Answer

Facial assessment based on photographs need to include complete quality pictures.
Each persons individual facial appearance is primarily based on bone structure. Soft tissue coverage tends to be very consistent from person to person and one allows each person to recognize others including seeing traits as masculine, feminine attractive or not so much is almost exclusively based on the fairly short skeletal structure. In order to make an assessment we need to see the relationship between the different bone structures in your face and skull. And a simplistic way we usually divide the face into the upper third mid third and lower third. The upper third it’s basically your for head and the bone structure there are the frontal bones. The mid phase goes from the base of your eyesocket to your upper teeth and this is generally referred to as the maxilla. lower part of the third is your mandible or jawbone.
In order to make the assessment accurately we need to see the relationship between these three segments of the face from proper angles which includes a frontal view and at minimum a lateral view or a profile picture.
Look at how plastic surgeons take before and after pictures to get an idea of how the pictures should be displayed.
Mug shots is another way to get an idea of how the pictures are taken since those are used for identification.
Avoid having facial expressions while taking the pictures. Frontal pictures should be taken with the camera aiming at the middle of the nose.
Profile pictures should be taken with the body standing straight looking forward and the camera pointing at the middle cheek coming in at right angles.
Most likely your issues stem from a mandible that is small in relationship to your maxilla.
It’s probably not your mid face that’s big but rather your mandible that small.I’m not a fan of buccal fat removal because facial aging typically involves loss of mid face volume and having that procedure can set up some individuals for premature facial aging.
Consider consulting with both oral surgeons and plastic surgeons to get different perspectives in regards to making an accurate assessment and having a clear understanding of what the dynamics are causing your face to look the way it does.
Recognize that soft tissue manipulation is going to be limited when the primary problem is based on bone structure.
Concerns regarding facial appearance especially individuals with a small or lacking mandible is one of the most common presentations on this website.
At least 95% of patients seeking chin and neck liposuction having as their primary underlying ideology a deficient mandible.
That doesn’t mean they can’t have liposuction but their fat distribution is usually normal and they wouldn’t have an issue if their mandible was more balanced and proportionate compared to the Maxilla.
Making accurate and quality facial assessments is not necessarily the easiest thing to do and you’ll find different plastic surgeons regardless of training and years of experience having different approaches and telling patients different things.
Because most plastic surgery procedures are based at manipulation of soft tissues and not facial skeletal structure they view the patient from a soft tissue perspective.
That makes a lot of sense but when the problem is truly based on bone structure soft tissue solutions are going to always be limited.
Best,
Mats Hagstrom MD

Procedures to slim lower face/cheek area? (Photo)

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