Would buccal fat removal or v-line be best?

It is a common misconception that a LeFort I osteotomy (impaction) will shorten the midface. What it accomplishes is to create less visible tooth show but it can not change the amount of overlying midfacial soft tissue cover. ( lip/philtral length) This can change the total vertical facial...

Hello ilovemacaroons, It's not possible to completely predict how much sagging you would have. A useful piece information is the amount of bone that will be removed. More or excessive bone removal would lean things towards more sagging. Your soft tissue is stripped off of the bone in the V line...

You do have a short chin that is round as most short chins are. From a bony standpoint a t-shaped genioplasty is needed to being it forward and narrow it. Another option is the v-shaped anatomic chin implant if one prefers a non-bone moving approach.