Nose deprojection and blephoplasty implant? (photos)

I feel my face is unbalanced. My nose I feel is too pinched and projected and I feel my face looks tired with loss of volume. What are my options please? I've tried filler it does not seem to stay longer than a few months and appears to migrate. How about thread lifting? What are your thoughts? I hear there are lower eyelid implants? What are you thoughts? Is there a way to tighten upper lids without upper blephoplasty? Also do I need a chin implant to also balance my face? Thank you

Doctor Answers 6

Facial Issues

Of all the facial tissues that you have mentioned rhinoplasty and chin augmentation would be the most beneficial and predictable. If any have either or both fat grafting to replace what you have been doing with filler would be the next facial volume treatment to try. 

Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Nose deprojection and blepharoplasty implant?

Thank you for your question.
The first thing that strikes me is that you are very young and really should not worry yourself about some the issues you have mentioned.
If I were to suggest any procedure that would help restore harmony and balance to your face, it would be an osseous genioplasty. A genioplasty allows the chin to be moved forwards, sideways and downwards. In your case, from the profile view that you have provided, it would seem that your chin is a little bit small and sits backwards. This is known as retrognathia. If your chin were moved forward by about 6mm, that would tremendously improve your facial balance.
Hope that helps.

Ivo Gwanmesia, FRCS(Plast)
London Plastic Surgeon
4.7 out of 5 stars 30 reviews

Nose deprojection and blephoplasty? Chin implant? What should I do??

Hello L.J. - Thanks for your question.Some amount of asymmetry is entirely normal to have.  You can certainly have some mild deprojection of your tip and bridge.  This will reduce the pinched appearance of your nose.  There is no reason for blepharoplasty in your situation.  There are non-surgical ways to tighten the upper lid using microneedling and RF skin tightening.  There are tear-trough implants that can be placed in the medial lower lid when someone has a very hollow tear-trough, but that is not your case.  A little bit of soft HA filler in the medial left lower lid might balance off your lower eyelid area.I'm not sure what type of filler you've used in the past, but a series of Radiesse injections might help bring your cheeks forward a bit to bring visual attention to your midface by filling it out a bit.A small, well-crafted chin implant might help balance off your face as well, but I would caution against putting in an oversized implant.Stay away from thread lifts as they are a waste of money!I hope this helps. Good luck, Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 55 reviews

I feel my face is unbalanced. My nose I feel is too pinched and projected and I feel my face looks tired with loss of volume.

Hi, I have performed many facial shaping and Rhinoplasty procedures over the past 30 years.  From the photos, your cheeks are quite flat anteriorly and the chin is weak.  This combines to create an elongated, oval shaped face.  The nasal tip appears over-projected which happens when the chin is weak as described below.  
 Following the beauty principles outlined in my book on face and body beauty, 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 or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 A weak chin creates an imbalance making 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 and highly effective.  In the off chance that the nasal tip still appears over-projected, once the chin is properly augmented and balanced, a limited procedure (does not require a full Rhinoplasty) can be performed on the nasal tip to reduce the projection.
This is a perfect example of where a Rhinoplasty or manipulation of the nose itself would "not" create a more feminine, heart shaped face.  This requires an adjustment to the cheeks and chin, not the nose. 
Hope this helps. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Facial Imbalance

Thank you for your question. I think you could be a great candidate for a couple procedures but I wouldn't recommend any kind of implant for under the eye or thread lifting. I would recommend adding a chin implant to give you more definition and give you a better balance to your profile. If you like the look of filler you could consider doing a fat transfer instead. Your surgeon would harvest your own fat from the abdomen, flanks or thigh area and transfer it to those areas of your face. Using your own fat can provide a very natural look and typically the fat will last, where a filler lasts between 10 months & a couple of years. A Rhinoplasty could also be an option for you if the projection of your nose is one of your concerns. Take your time and find a board certified surgeon to consult with. I would also look at before and after photos to help make a decision.

John Allan Ness, MD
Minneapolis Plastic Surgeon
4.9 out of 5 stars 42 reviews

Rejuvenating your nose and face

Hi.  First of all, slow down! You dont need most of the procedures you are mentioning! You are way too young for most of that.  Thread lift?? Oh absolutely not! Lower lid implants?? Definitely no!
You would benefit from a small chin implant.  You would benefit from either non-surgical rhinoplasty to build up the bridge and radix to reduce the over projected appearance of the tip or a good structural rhinoplasty to make the tip less projected.  In either case the bridge and radix do need to be elevated slightly.  You would also benefit from fillers to the upper cheeks to give you more of a heart shaped youthful face.  But there is nothing wrong with your eyelids or face.  

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 106 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.