Unsure of the right procedure: submental lipo, kybella, or buccal fat removal. Areas of concern: side profile.

Question

I want to be certain before getting a certain procedure that it's going to be the right procedure that will give me the results I want. I'm more concerned with having a nice side profile. I hear and have read that buccal fat removal barely does much unless one has really fatty cheeks. I am not open to chin implant, etc. Would prefer no surgery if at all possible. I'm not sure if it helps should I lose some weight in the face. Which procedure would I need (if any)?

Benjamin Caughlin, MD, FACS · Answer

Thank you for your question. Looking at your photos, I would recommend submental fat liposuction with transfer to the chin to maximize your profile view. You would be surprise what a little chin projection will do along with liposuction to really sculpt the neck angle which is a very attractive feature. Hope this helps.Best of luck,DrC

Afshin Farzadmehr, MD · Answer

simple procedure takes 0 minutes with tumescent and mild sedation in an approved surgical facility is gold standard treatment with best and fastest recovery results and the money expense.

Daniel Barrett, MD · Answer

Dear m4jr,Kybella typically takes 3 to 5 treatments to work. This is why I've stopped carrying Kybella in my office.  I recommend neck liposuction more often then any injectable procedure for the neck now. It provides superior results gives me more control over the area than any injectable. The liposuction can be done under local while awake in the office and recovery is about the same as kybella. I would suggest you to consult a board-certified plastic surgeon. You will get the best recommendations after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tania Medina de Garcia, MD · Answer

Hello dear
Thanks for the question and provided information as well. 
  
Based on your photo you are a good candidate for chin liposuction, 
Chin liposuction can be an option, it makes you look younger and more
 attractive with a sharp jawline , and better facial proportions.It is 
important evaluate your pictures or a personal evaluation in order to 
give you the best option for your case. 
I recommend you to make an appointment with a board certified plastic 
surgeon for a good evaluation and to talk about your goals.
Good luck :)

Paul J. Leahy, MD · Answer

Thanks for your question. It sounds like you've done a lot of research and thinking about what look you are after; that is great! I think you would likely be a good candidate for Kybella. As you may know, it's a series of injections (typically our patients get 2 rounds separated by 6 weeks). It stings a bit during the procedure, but it's very fast. It does swell for a week, but results have been very encouraging. Smartlipo is another choice, but if you are not wanting surgery, Kybella would likely be best for you.

Michael Zarrabi, MD · Answer

This is a wonderful question and you have already read some great answers.  I think buccal fat pad removal is a nice idea. It will make a nice change and reduce the fullness of the cheeks.  This may not make the most profound change to your "profile" but will help. Trying to loose weight is fine but there is no way to specifically loose weight in your face.  Your chin is not very prominent and is actually pushed back a little. There is also some mild fat under the chin, in the neck area. My suggestion would be to have a chin implant with liposuction under the chin.  Buccal fat pad removal would be the icing on the cake.

William Portuese, MD · Answer

The side profile photograph demonstrates a weak and a recessive chin profile, for which a chin implant can improve. Liposuction can accomplish removal of the small amount of fatty deposits in the neck. For more information and many examples of both procedures performed together and separately, please see the video and the link below

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

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin or lip implants), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front, there is excess fat in the lower face (more on one side), the chin is weak as are the back portions of the jaw line.  These combine to create an elongated, thin, rectangularly shaped face with a weak profile.  
 Following my beauty principles, 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.  Liposuction can be done to decrease the excess fat in the lower face.  Buccal lipectomy, is removal of fat below the front portion of the cheeks which in my opinion does not have the ability to add shape or volume to the cheeks themselves but can cause hollowness below the cheeks.
 I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  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, 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.  If you are not interested in a chin implant, dermal filler can be used to augment the chin. 
 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).  
  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Jon A. Perlman, MD (retired) · Answer

Thank you for your question and photographs. Since her head is twisted rather than in a pure profile position it is a little difficult to judge so I would strongly recommend that you consider a face-to-face consultation with a board-certified plastic surgeon. If there is fat padding in the submental area you have an option of Kybella or submental liposuction but keep in mind that the nonsurgical treatment can be as or more expensive than a simple liposuction procedure. You also appear to be a candidate for buccal fat pad removal to reduce the fullness in your lower cheeks but you should consider and be open-minded to the possibility of either filler injection to your chin or placement of a chin implant. A detailed face-to-face consultation should be helpful in allowing you to discuss your options and the relative merits of each procedure.

Please enjoy the video link below for discussion of non-aggressive ways to change the appearance of your face. Best wishes,
Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

Please enjoy the video link below for discussion of non-aggressive ways to change the appearance of your face.  Best wishes,
Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

David Alessi, MD - Account Suspended · Answer

You would benefit from either Kybella or liposuction.  We have a lot of experience with both and either would work for you for the tissue under the chin.  Typically, 2-3 treatments with Kybella would suffice.  I never have had to go more than 3 treatments.  The cheeks can only be reduced with a buccal fat pad removal. Kybella isn't approved for use in this area.  Best wishes.

Unsure of the right procedure: submental lipo, kybella, or buccal fat removal. Areas of concern: side profile.

Answers (10)

More Chin Liposuction Questions

WE SEND PRETTY
EMAILS

Answers (10)

More Chin Liposuction Questions

Discouraged by crooked smile after chin/neck lipo. How to hasten the healing process of a damaged nerve?

I hate my chin and jawline and submental fullness. What do you recommend? (photos)

If I already have a chin implant, is it safe to get lipo?

Still swollen at 2 months post chin liposuction

Bands forming after neck lipo? How do I get rid of this? (photo)

Best procedure for me (jawline) feel like I have a double chin. (photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS