Prefer a non invasive procedure, no filler. Uneven chin and cheek bulges - chin lipo or Botox? (Photos)

Question

I have always been insecure about the bottom half of my face, particularly when I smile because of my uneven chin and weird cheek bulges (jowls?). I do have a bit of a double chin from the side and I think it might be recessed but I honestly don’t mind this, it’s my front profile I am most concerned about. Is the issue I have an issue because of fat, or is it more musclebased? I do have TMJ that causes my mouth to move towards the right hand side so I was wondering if masseter Botox might also work. Ideally I am looking for a non invasive procedure and no filler I have attached photos from different angles! The left side of my chin is more dimpled than my right and there is more skin there to grab. Due to my TMJ I talk more out of the right side of my mouth so I’m not sure if this plays a role. I have been told by my dentist that the structure of the jaw itself is fine.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Addressing your concerns about uneven chin and cheek bulges, particularly with a preference for non-invasive procedures and avoiding fillers, involves understanding the underlying causes and selecting appropriate treatments. Your description suggests that the asymmetry and bulges may be due to a combination of muscle activity, fat deposits, and skin laxity. Given your TMJ condition, which causes your mouth to move towards the right side, there is likely an element of muscle imbalance contributing to the asymmetry, particularly in the masseter muscle.

Masseter Botox is a non-invasive treatment that can effectively address muscle-related asymmetry. Botox works by temporarily weakening the masseter muscle, which can become hypertrophied due to overuse, especially in cases of TMJ. By reducing the size of this muscle, Botox can help achieve a more symmetrical appearance of the jawline and lower face. This treatment is particularly beneficial if the muscle bulk is a significant contributor to the unevenness you experience. The effects of Botox typically last between three to six months, after which repeat treatments may be necessary to maintain the results.

In addition to muscle-related issues, if there are significant fat deposits and skin laxity contributing to the unevenness and bulges, a minimally invasive procedure like FaceTite could be considered. FaceTite uses radiofrequency-assisted lipolysis to deliver controlled energy beneath the skin, which helps to coagulate fat and tighten the skin. This dual action can improve the contour of the face by reducing jowls and enhancing the definition of the chin and jawline. FaceTite is particularly effective for individuals who have mild to moderate skin laxity and want to avoid more invasive surgical procedures like a facelift.

Starting with masseter Botox is a strategic initial step, as it directly addresses the muscle imbalance caused by TMJ. This treatment can provide a noticeable improvement in facial symmetry and contour without the need for surgery or downtime. If, after addressing the muscle component, there remains a concern about fat and skin laxity, FaceTite can be a complementary procedure. It offers the advantage of tightening the skin and reducing fat, further enhancing the overall appearance of the lower face.

It is important to have a thorough clinical evaluation by a dermatologist or facial aesthetic specialist to assess the specific contributions of muscle, fat, and skin to your concerns. This evaluation will help tailor the treatment plan to your unique needs, ensuring the best possible outcome. Non-invasive treatments like Botox and FaceTite have the benefit of minimal downtime and low risk compared to surgical options, making them attractive choices for individuals seeking subtle yet effective improvements.

In summary, for your uneven chin and cheek bulges, starting with masseter Botox can effectively address muscle-related asymmetry due to TMJ. If additional contouring is needed, FaceTite offers a minimally invasive solution to tighten skin and reduce fat, enhancing the overall symmetry and appearance of your face. This combined approach targets both muscle and soft tissue components, providing a comprehensive solution to your aesthetic concerns.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics are almost entirely based on facial skeletal structure.
Soft tissue coverage tends to be very even from person to person.
Any joint in your body that has movement needs skin redundancy to allow for full extension.
When you flex your neck, there will be skin redundancy in the submental area.
This is normal and true for all people.
Likewise, when you contract muscles, there will be skin redundancy that in some cases will form fullness or a wrinkle.
This is normal.You don’t need any treatment.
None of your concerns are going to be corrected by either Botox or filler or surgical intervention. Save your money for something more useful.
Your normal.
You don’t need intervention
Best,
Mats Hagstrom MD

Prefer a non invasive procedure, no filler. Uneven chin and cheek bulges - chin lipo or Botox? (Photos)

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Prefer a non invasive procedure, no filler. Uneven chin and cheek bulges - chin lipo or Botox? (Photos)

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