If you've struggled to get the jawline of your dreams despite diet and exercise, have jowls and loose skin beginning to obscure your jawline or noticed that you may be prone or predisposed to never having a defined jawline despite excellent overall health and fitness, fear not! Thanks to modern plastic surgery, you have some nonsurgical and surgical options available.
Nonsurgical options are best for patients who have mild to moderate fat obscuring the jawline, a fairly well-defined chin area and minimal to moderate loose skin around the jawline. Options include dermal fillers, neurotoxins, fat melting injectable agents and surgical threads.
By injecting dermal fillers to directly to the jawline, the edge of your bony angle and mandible is enhanced. This works best in patients who are "almost there" but do not quite have a hard bony edge that you can see.
Typically you will need 1-4 syringes of dermal fillers, based on your anatomy and how defined you want your jawline. The results are immediate and should last about 12-18 months, depending on the dermal filler used.
Botulinum toxin (Botox, Dysport or Xeomin) can be placed directly in the masseter muscles of the face, which will slim your overall facial shape into a slightly more "V" like shape.
You can feel your masseter muscles by clenching your teeth and feeling a slight bulge at the end of your jaw. Thinning out the masseter muscle requires a fair amount of neurotoxin, usually about 30-60 units of Botox/Xeomin or 84-168 units of Dysport per side to achieve visible results. These results last about 3-4 months.
If you have some mild excess fat, you can melt this fat with a melting agent called Kybella (deoxycholic acid). The area in the double chin is considered on-label use, but getting to the very sides and back portion of your jawline may require injections that are off-label use. Depending on how much fat you have in the jaw area, you will need 1-6 vials of Kybella. The results are permanent, assuming you maintain your overall weight since the fat is physically melted.
Surgical threads can be placed around your jowls to tighten your slightly loose skin. You will probably need anywhere from 4-8 threads, depending on how large your jowls are and how much loose skin you have. Surgical threads generally last 6-12 months.
Surgical options are for patients who have a moderate to larger amount of fat and loose skin around the neck and jawline areas. The main treatments are liposuction or neck lift or both. Another new technology is radiofrequency energy.
If you have fat that is just under the skin and not underneath your neck muscles, liposuction of the neck and jawline area can be done to remove fat and give you a nicely defined jawline. Depending on the technology used, you will have mild to moderate skin tightening with liposuction as well. Results will last years or a lifetime since the fat is physically removed.
After making incisions near your ear and behind your ear, as well as an incision underneath your chin, your neck skin is lifted up, revealing access to your neck muscles, fat and supporting structures or your neck. A neck lift allows the most access and best long-term results, because all of the structures that can make your jawline more defined – skin, fat, muscle, SMAS, salivary glands – can be addressed in one procedure to give you maximal results that will last for years.
Radiofrequency energy can tighten loose skin and, in the neck area, can be used to tighten the skin after some type of procedure, usually neck liposuction. RF can be used with other procedures to tighten your neck skin and your redraped neck skin will be more smoothly and tightly placed over your jawline.
What are your best options for the jawline of your dreams? You can realistically assess your neck and jawline at home, and a consultation with a board-certified plastic surgeon will give you your best options. The American Society of Plastic Surgeons (ASPS) has information about all of the procedures mentioned as well as a list of plastic surgeons in your local area.