Bad bone structure or too much face fat or both? (Photo)

Question

Wondering what causes my face shape, whether it's fat or not enough support (like the bone structure)? Options I've considered are buccal removal, or smart lipo on the neck/jawline, however I don't know if either is right for me. Maybe chin implant, or even cheekbone implants? I am not fat in the body and never have been, and I'm only 19. Just don't have a clue really! Any advice would be helpful.

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam your question cannot be answered.  You will need to see an Oral/Maxillofacial surgeon to see if othognathic surgery, genioplasty or using an implant is best for your specific case. It should be noted that patients with severely weak jaws or abnormally functioning jaws may be better treated with other facial surgery (orthognathic surgery), although a chin augmentation may be an option at a later time. These patients should seek the advice of a plastic surgeon to determine which course is right for them. Here is some information to help you make this decision: Candidates for Chin Augmentation - Patients whose chin profiles are weak but have normally functioning jaws are candidates for Chin Augmentation. Many of these candidates have used injectable fillers in the past to strengthen the protrusion of their chins, but are looking for a permanent solution. If you are one of these patients, then you are a likely candidate for chin augmentation
#weakchin #chinimplant

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are flat in the front, there is indeed excess fat in front of the cheeks, the chin is weak as are the back portions of the jaw line.  These combine to create an elongated, rectangularly shaped face.  
 Following my facial beauty principles that I've developed over the past 30 years, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler (temporary result) or using silastic cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Liposuction would be added to reduce the excess fat and further shape the cheeks and face.
 I have performed many Chin Augmentations using chin implants for over 30 years.  A facial imbalance is created when the chin is weak that makes: the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft). Hope this helps.

Val Lambros, MD, FACS (retired) · Answer

Please. You are young and beautiful,  you have the kind of face that young people have, which is full. This will go away in its own course and you will wish you had it back.  Do NOT do buccal fat removal. In 10 years it will look hollow and terrible. If you MUST do something, which I don't see the need for, do nothing more aggressive than HA fillers like restylane/juvederm which can be reversed.

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