Thank you for your question.
You submitted a question without a photo and I think this is somewhat a little bit of limitation
of how I answer your question but I can certainly give you some global understanding of my perception
and considerations with a situation like yours.
You’ve described a situation where you’ve had both chin and jaw reduction surgery and
you’re unhappy with the results.
You state that you have an asymmetric chin that looks like more of a “V”.
You want it to look like a “U” and that you have some pre-jowl, a sulcus and you are
aware that there are such things such as pre-jowl implants.
You want a permanent solution.
Well, I can certainly give you some guidance.
A little bit of background before we move forward, I’m a Board-certified cosmetic
surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Facial aging solutions and facial aesthetics is a significant part of my practice.
And so I can certainly give some overall perspective of what I hear when I see a question like
this and how I interpret this.
To begin with, you went through something very significant of what’s called orthognathic
surgery.
This is something you underwent most likely with a maxillofacial surgeon and it’s significant
because most likely, you had an issue with teeth occlusion as well as facial appearance.
Now once everything’s been set, if you have these concerns, I think my first thought would
be is have you addressed this with your doctor and does your doctor or surgeons who performed
the surgery have some idea of what they can do to help you look a little bit better.
You know, if you are looking for a permanent solution, most likely, the surgeons who performed
this surgery will have the best idea of what is optimal if you are looking for a permanent
solution whether it’s some kind of a bone grafting procedure, whether it’s facial
implant surgery.
That basically covers permanent solutions.
Now speaking in terms of what can be done if you’re not sure if those permanent solutions
would be right for you or maybe you would be dissatisfied with those permanent solutions,
I would actually consider doing something, although it may not be permanent, you can
get a sense of what it would look like with maybe these permanent solutions.
Maybe not exactly but it could give you an idea.
So what I’m talking about is a procedure we perform in our practice using hyaluronic
acid fillers that are on the thicker side such as Juvederm Ultra Plus and Juvederm Voluma
and the procedure is called structural volumizing.
Structural volumizing essentially means addressing a deficit in areas at the bone level.
Traditional filler placement is typically done just under the skin or in the skin, intradermal,
subcutaneous.
When we do structural volumizing, we’re actually placing these thicker fillers at
the bone level.
And where do we place them?
We place them typically in the cheekbone area, in the jawline, the prejowl area, the chin
and in the jaw angle.
This combination or parts can actually have a significant impact on the appearance.
And what’s really nice and remarkable about this is that you would have minimal bruising
and you can actually see close to what the final result would be almost immediately.
Now of course, there’s a certain amount of swelling that can be part of the initial
adaptation process and progression of normal balance.
And in two weeks, you can actually get a better sense of what that would look like.
But I think that, given how extensive your surgery was, it’s unfortunate that you’re
still dissatisfied with the outcome.
I would suspect that you do have a significant improvement more globally and now what you’re
doing is looking at the fine points of areas you would like to see improve.
So I think that when it comes to doing something in the fine points, the injectable fillers
actually gives us a lot of flexibility.
And even if we’re not just structural volumizing, it can be a combination of structural volumizing
and soft tissue augmentation with fillers.
So I think that you can consider that and have this dialogue with your original surgeons
about the areas because maybe it’s an interesting idea to have that procedure and then take
some photos and show your surgeons that this is what you would like long-term and see if
it’s attainable.
So meet with qualified, experienced physicians who are familiar with this method or technique.
Most doctors don’t do this.
This is something that’s kind of a specialized approach to using fillers and then take it
from there and hopefully you’ll get closer to the ideal that you’re pursuing.
So I hope that was helpful, I wish you the best of luck and thank you for your question.