How Can I Make My Elongated Face Shorter?

Q: Dr. Eppley, Concerning the result I want to receive from facial surgery, I would like to systematically explain my problem:

Before puberty I was looking like normal but at the age of 15-18 I experienced elongation of my face. So much that I cannot recognize myself anymore in the mirror. The “T” zone of my face became extremely elongated during those years. Making me so insecure about myself. I never understood what was the cause of my problem – why my face deformed so extremely? 

The procedures I was considering for my condition were: Mandible jaw implants, cheekbone implants, maxilofacial sugery, rhinoplasty, lip lift, fat transfer under the eyes, or lower blepheroplasty.

I have very flat sides of the face. At first I wanted to do mandible jaw implants (that goes into width) – to widen my face. But then I was afraid it might make my face masculine, giving the fact that the T-zone of my face is extremely long. How is it possible to reduce the elongation of my face and make my face healthy and feminine looking? Also, I was thinking about fat-transfer to my under-eye and cheeks, but then I was afraid it might just make my face puffy and elongate the T-zone even more.

Ever since I was 16 I dreamed of some operation that would get my face back to normal. Is there any chance of converting my deformed face back to normal?

A: Thank you for your inquiry and sending your pictures to which I can say the following:

1) What has occurred in your face is normal development after puberty. It is not a true facial deformity per se.  You simply liked your more pubescent face than what mature facial development has created. That does not negate that your do not like the facial proportions that have resulted. (long midface and shorter lower face)

2) You can not really shorten the middle third of the face as effectively as changing the lengths of the upper and lower face. That has always been and will always be a challenge. There are only a few limited changes that can be done that can help soften the length of the midface.

3) That being said one surgical approach is chin/jaw augmentation to increase the size of the lower face.  As you have mentioned one must be careful in a female to not masculinize their face. The best way to make that determination is computer imaging to see what such a potential change would look like. Your reaction to that imaged change will determine if this is an acceptable or unacceptable change. (see attached imaging)

4) The aforementioned midface shortening procedure would be  subnasal lip lift and a rhinoplasty that shorten the length of the nose.. I have put those changes on top of the jaw augmentation to show all procedures that may be helpful in improving your facial third proportions.

Dr. Barry Eppley

World-Renowned Plastic Surgeon