Help! How do I get chiseled high cheeks without looking puffy, and slim down my square jaw/lower face? (Photo)

Question

I've seen a few doctors and they have all quoted me 4cc voluma to " almost impossible to get "kardashian" cheek look. :( I'm lost. I've added photos to make it more clear what i want. I feel like i am being taken advantage of during the consult and quoted extremely different pricing. What do I do?

Jason Emer, MD · Answer

Facial sculpting and symmetry of the face can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra, which would give a more chiseled look to the cheekbones. Implants or fat are an alternative. The jawline can be sculpted and slimmed with Botox. See an expert in facial sculpting for a formal evaluation. Best, Dr. Emer

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

Hi, I have performed many facial shaping procedures over the past 30 years using dermal filler, facial implants (cheek implants, chin implants, lip implants), liposuction and/or SMAS facelifts.  Comparing your photos with the examples provided your cheeks are extremely flat in the front, there is some excess fat in the lower face that further blunts the cheek shape, the chin is weak as are the back portions of the jaw line.  In addition, the upper lip is very thin.  These all combine to create an elongated, rectangularly shaped face.  However this doesn't mean that your jaw and lower face are square or masculine...quite the contrary, your jaw line and lower face are very weak when compared to the other women's faces that you provided.
 Following the facial beauty principles that I've developed over the past 30 years, women look the most feminine and attractive (as evidenced by your examples) when they have heart shaped faces.  My studies have shown that heart shaped faces have shapely cheeks that are full and round in the front.  Your cheeks can be similarly shaped, with a Cheek Augmentation using either a dermal filler or silastic cheek implants for a permanent enhancement, that will soften and feminize the entire face.  It's paramount that when using a dermal filler that the front portion of the cheeks be augmented, not the outer portions which will tend to broaden and masculinize the cheeks and face.  Reduction of the excess fat with liposuction will further shape the cheeks and face.  When excess fat surrounds the cheeks, it' best in my humble opinion, to combine liposuction that reduces the excess fat along with placement of silastic cheek implants to create more soft and feminine shaped cheeks.  This combination will decrease the overall size of the mid face while making it more feminine and naturally attractive.  In comparison, adding a significant amount of "any" dermal filler to the cheeks will add volume  and increase the overall size of the mid face when added to any area that already has excess fatty tissue.  In my humble opinion, this creates the "puffy", over blown up faces.
  A weak chin creates facial imbalance making the nose look larger, the mid face "top heavy", while the lower face appears foreshortened which tends to de-emphasize lip fullness and allowing early formation of a double chin.  I have performed many chin implant procedures over the past 30 years and place silastic chin implants, through a small curved incision under the chin, in 30 minutes or less often using local anesthetic alone.   In my experience this procedure is very safe, quick, highly effective and far less invasive than a sliding genioplasty.
 The upper lip can be augmented (my beauty principles define ideal lips as being full and proportioned when the upper lip is approximately 75% as full as the lower lip) using a dermal filler or a perma lip implant for a permanent lp enhancement.  Similarly, the back portion of the jaw line can be augmented with precise placement of a dermal filler to correct the weak jaw line without masculinizing the jaw line and face.  Jaw implants have too many unwanted side effects in my humble opinion.  Additionally, in my opinion and experience, fat transfer (fat injections) offer far less of a reliable and predictable volume than an off the shelf dermal filler or silastic facial implants and for that reason I do not use fat to shape the cheeks, chin, lips or jaw line.
Hope this helps.

Help! How do I get chiseled high cheeks without looking puffy, and slim down my square jaw/lower face? (Photo)

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